In the nursing home, most care and care decisions revolve around nurses, because doctors and other medical providers are often not in the building. If you are a nursing home nurse, you may have learned many things that in the past were routinely done but that no longer considered appropriate. For example, we now know that a positive urine culture in a nursing home patient who is not sick is not a reasons to prescribe antibiotics, and that first line treatment for bronchitis or even many COPD exacerbations does not include antibiotics. We’ve also learned that nurses often ask doctors and other providers for antibiotics in situations when they are not needed, in many times because they feel that patients or families would want an antibiotic. These and other issues around antibiotic stewardship are complex but are necessary for good medical practice nowadays.

Changing practice takes leadership, education, re-thinking old ways, and ongoing quality improvement. We understand that these issues are complex, and that frail nursing home residents present special challenges. This website provides (and over time will add more) resources to help nursing home nurses better understand both the science and the practicalities of antibiotic stewardship, and apply it in their everyday practice.

Below is a description of the modules. Click the button below to get started:

Session 1 (Modules 1-5) introduces the problem of antibiotic resistance and then focuses on diagnosis and treatment of suspected urine infections. This training is designed to help nurses communicate more effectively and work together with medical providers, residents and their families to ensure that antibiotics are used only when they are really needed.

Session 2 (Modules 6-10) looks at suspected respiratory and skin/soft tissue infections and then pull it all together by describing 12 common situations when antibiotics are commonly prescribed but rarely needed.

Get Started With Training

Downloadable decision and communication aids:

 General Guidelines For Urine Testing

Nurse SBAR Skin/Soft Tissue Worksheet Nurse SBAR Urinary Worksheet Nurse SBAR Respiratory Worksheet

AHRQ Antibiotic Stewardship Guide

CDC Core Elements of Antibiotic Stewardship

Minnesota Department of Health Antibiotic Stewardship Toolkit

Nebraska Antimicrobial Stewardship Assessment and Promotion Program

Short video on colonization versus infection: