Sierra View Earns CDPH Gold Antimicrobial Stewardship Designation

Sierra View Medical Center has earned a Gold designation on the California Department of Public Health Healthcare-Associated Infections Antimicrobial Stewardship Honor Roll. The Gold designation is valid for three years, through August 31, 2028. To achieve Gold, hospitals must demonstrate strong antimicrobial stewardship practices, measurable outcomes, and meaningful community engagement. This statewide recognition reflects Sierra View’s commitment to using antibiotics responsibly, recognizing sepsis early, and working collaboratively to protect patient safety both inside the hospital and throughout the community.

Antimicrobial stewardship plays a critical role in patient safety. According to the Centers for Disease Control and Prevention, at least 30 percent of antibiotics prescribed in U.S. healthcare settings are unnecessary or inappropriate, increasing the risk of antibiotic resistance and limiting effective treatment options when patients truly need them.

Sepsis Alert and Antibiotic Stewardship Project

A key contributor to this achievement was an evidence-based project led by the Vizient/AACN Nurse Residency Program Cohort 15, in collaboration with Sierra View’s Pharmacy Department. The project, Sepsis Alert and Antibiotic Stewardship, partnered with Sierra Valley Rehab Center, a local skilled nursing facility, to strengthen sepsis recognition and support appropriate antibiotic use among healthcare staff caring for vulnerable patients.

Sepsis is a medical emergency that occurs when the body’s response to infection causes widespread inflammation and organ damage. It can worsen quickly and become life-threatening if not treated early. Each year, at least 1.7 million adults in the U.S. develop sepsis, and nearly 350,000 die during hospitalization or shortly after discharge, according to the Centers for Disease Control and Prevention. Older adults and individuals with complex medical conditions face a higher risk, making early identification and timely treatment especially important in rehabilitation and long-term care environments.

Early recognition of infection, timely culture collection, and appropriate antibiotic selection are essential steps in preventing sepsis from progressing and reducing the risk of serious complications.

Education That Supports Early Action

Recognizing these risks, Cohort 15 focused on bringing practical education and clear tools directly to healthcare staff. Using an evidence-based framework, the team developed an interdisciplinary education program that emphasized recognizing early signs and symptoms of sepsis, understanding appropriate timing for cultures and antibiotics, and reinforcing core principles of antibiotic stewardship.

Education sessions were supported by a Sepsis Alert checklist, designed to guide decision-making and encourage a consistent response when sepsis is suspected. These tools helped staff move quickly from recognition to action, when every minute can make a meaningful difference.

Measurable Outcomes and Nurse Residency Leadership

To evaluate the impact of the project, healthcare staff at Sierra Valley Rehab Center completed surveys before and after the education sessions. Results showed improved confidence in recognizing sepsis symptoms, increased awareness of existing protocols, and greater engagement in antibiotic-related decision-making.

The project was completed as part of the Vizient/AACN Nurse Residency Program’s final evidence-based practice presentations for the 2024-2025 residency year. Cohort 15 nurses who contributed to this work include Karen Anderson, Brandon Ramirez, Cristal Munoz-Chavez, Michaela Peyron, Kayla Drake, and Wilson Orpilla. Representing clinical areas such as medical-surgical care, intensive care, emergency services, labor and delivery, obstetrics, and float pool nursing, the group brought diverse perspectives to a shared focus on patient safety and quality improvement.

“The nurses in Cohort Group 15 researched and subsequently developed and implemented a community focused and collaborative evidence-based initiative. As an integral part of the healthcare team, nursing care extends far beyond the hospital’s doors. In educating and working with our community partners, the primary goal is to deliver high-quality, safe nursing care both inside the hospital and in the surrounding patient population.

Evidence-based nursing practice (EBP) has repeatedly been shown to improve patient outcomes, safety, and care quality. This is achieved by integrating the best evidence with clinical expertise and patient values. EBP reduces complications, shortens hospital stays and readmissions, lowers healthcare costs, and enhances nurse autonomy and confidence. Key benefits include current best practice with patient-centered care, and a reduction in errors."

Christine Williams MSN, RN, CCRN, PHN, Clinical Educator and Nurse Residency Program Coordinator

Collaboration That Strengthens Community Care

Guidance from Sierra View’s Pharmacy Department helped ensure the project aligned with best practices in antimicrobial stewardship and met California Department of Public Health Gold designation requirements. Pharmacy collaboration reinforced evidence-based education and highlighted the importance of using antibiotics appropriately, particularly in settings where patients are at higher risk for complications.

“Earning the California Department of Public Health (CDPH) Gold Antimicrobial Stewardship Honor Roll designation affirms Sierra View’s deep commitment to patient safety and responsible antibiotic use. This highest-level recognition reflects our team’s success in optimizing antimicrobial therapy, reducing the risk of resistant infections and C. difficile, and collaborating with community partners to ensure our patients receive safe, effective, and evidence-based care every day. Special recognition goes to our pharmacists who actively intervene daily to make recommendations optimizing patient care, as well as to our Antimicrobial Stewardship team, which has come together and achieved all of the internal requirements for this recognition.”

Bryan Brassfield, Director of Pharmacy

The California Department of Public Health review process for Gold designation includes multiple phases, such as evaluation of stewardship outcomes, community engagement, and external expert review. Sierra View’s successful designation reflects the strength of collaboration between our Nurse Residency Program, Pharmacy Department, and community partners.

Earning Gold designation represents more than an award. It reflects a shared commitment to improving patient outcomes, supporting healthcare education, and strengthening partnerships that help deliver safer care across the community.