Tools for AMS TOC Programs

It is helpful to have tools for implementing an AMS TOC program. Below are tools to help standardize patient assessment and clinician implement such a program.

Planning your process can takes time and requires collaborative discussion. Consider using a brainstorming tool (downloadable worksheet) to talk through the steps with each of your stakeholders.

Optimizing antimicrobial therapy includes determining the appropriate agent, dose, route, frequency and length of therapy. Institutions should take local antimicrobial sensitivity patterns into account when creating institutional guidelines for the choice of therapy. Additionally, sensitivity patterns may differ between the inpatient and outpatient settings. And, regardless of the setting, antimicrobial agent length of therapy should not exceed recommendations. Treatment and length of therapy guidelines should be in place before creating a formal AMS TOC program.

Downloadable Resources:

• Program Overview
• Initial Assessment – Gap Analysis
• Implementation Planning – Stakeholder Discussions
• Example Pharmacist Workflow
• Example Institutional Guidelines
• Multidisciplinary Implementation Handout

Counting the days of antimicrobial therapy is an important step in optimizing therapy. Any clinician involved with AMS TOC should understand how to count days of therapy. Day one antimicrobial therapy is the first day the patient receives a dose of active therapy.

The AMS TOC plan should be documented in the medical record for any clinician to access. This note should include infection and therapy related information and the plan for discharge.