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Antimicrobial Stewardship
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Antimicrobial Stewardship: Implementation Tools & Resources

This section provides additional resources for individuals interested in antimicrobial stewardship programs, including Materials and Forms and Other Resources.

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Materials and Forms

Contributed by Allina Regional Hospital Cardinal Health Pharmacy Solutions, Columbia University Medical Center, and the Johns Hopkins Hospital

  • Tools for Daily Activities of Stewardship (also see IV to PO tools):
    • Peri-Operative Antibiotic Prophylaxis Blank Poster, PDF (39 KB)
    • Adult Inpatient Antibiotic Approval Form, PDF (51 KB)
    • Antibiotic Recommendation Form, PDF (20 KB)
    • Blank Order Set for Antifungal Therapy, PDF (27 KB)

  • Policies, Procedures, and Guidelines:
    • Streamlining Policy and Procedure, PDF (21 KB)
    • Sample Daily Pharmacist Checklist, PDF (78 KB)
    • Drug Use Evaluation Form, PDF (99 KB)
    • IV to PO Guidelines, PDF (38 KB)
    • IV to PO Worksheet, PDF (24 KB)
    • IV to PO Reference Sheet, PDF (22 KB)

  • Business Case, Request for Proposal, and Job Description Examples:
    • Antimicrobial Stewardship Program Proposal Sample 1, PDF (112 KB)
    • Cost Analysis, PDF (14 KB)
    • Cover Letter, PDF (73, KB)
    • Antimicrobial Stewardship Program Proposal Sample 2, PDF (36 KB)
    • RFP for ID Consultation and Post Prescription Antibiotic Rounding, Allina Regional Hospital, 2008, PDF (104 KB)
    • ID Pharmacist Job Description, PDF (62 KB)

 

Other Resources