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- Title
Evaluation of an Automated, Pharmacist-Driven, Antimicrobial Patient Acuity Scoring System for Hospitalized Bacteremic Patients.
- Authors
Karpen, Riley; Murphy, Claire; Reed, Erica; Gerlach, Anthony T.; Cape, Kari; Mellett, John; Atyia, Sara A.
- Abstract
Purpose: The implementation of an automated, pharmacist-driven, scoring system within the EMR has been shown to improve patient care in patients with Staphylococcus aureus bacteremia by increasing the adherence to disease specific quality-of-care measures. However, there are a lack of studies evaluating the incorporation of blood culture review into standard, non-antimicrobial stewardship pharmacist workflow. Our institution implemented an automated, pharmacist-driven, antimicrobial scoring system in the electronic medical record (EMR) on August 6, 2019. Methods: This was a retrospective, single-center, quasi-experimental study of hospitalized, non-critically ill adult (18-89 years of age) patients with bacteremia between July 6, 2018 and July 5, 2019 (pre-implementation group) and September 6, 2019 and September 5, 2020 (post-implementation group). The primary outcome was time to directed antibiotic therapy in patients with positive blood cultures. Secondary outcomes included hospital length-of-stay, days of therapy (DOT) while inpatient, time to effective therapy, 30-day all-cause mortality, and rates of Clostridioides difficile infections documented within 3 months of positive culture results. Results: Implementation of the antimicrobial scoring system did not result in a significant change in time to directed antibiotic therapy (32.5 hours vs 37.4 hours; P =.757). There was also no difference found for time to effective antibiotic therapy (−12.6 hours vs −14.2 hours; P =.905) and no difference found for all other secondary outcomes. Conclusion: The implementation of the antimicrobial scoring system did not lead to an improvement in clinical outcomes. Further research is needed to better define a patient population that may benefit from this system.
- Subjects
ANTIBIOTICS; BACTEREMIA; MEDICAL quality control; EVALUATION of medical care; LENGTH of stay in hospitals; RESEARCH methodology; MORTALITY; CLASSIFICATION; RETROSPECTIVE studies; CLOSTRIDIOIDES difficile; PATIENTS; TREATMENT duration; STAPHYLOCOCCAL diseases; MEDICAL protocols; HUMAN services programs; WORKFLOW; CLOSTRIDIUM diseases; HOSPITAL care; AUTOMATION; QUALITY assurance; ELECTRONIC health records; MICROBIAL sensitivity tests; EVALUATION
- Publication
Hospital Pharmacy, 2024, Vol 59, Issue 1, p32
- ISSN
0018-5787
- Publication type
Article
- DOI
10.1177/00185787231182567