Automated Dispensing Cabinet Alert Improves Compliance with Obtaining Blood Cultures Before Antibiotic Administration for Patients Admitted with Pneumonia

Sikka, Rishi; Sweis, Rolla T.; Kaucky, Carleen; Kulstad, Erik

doi:10.1016/s1553-7250(12)38028-8

Cited by 9 publications

(8 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most evidence came from specialty settings (such as intensive care, emergency medicine and paediatrics); and from high‐risk patient groups (e.g. those at risk for or with infections); and from tertiary care …”

Section: Resultsmentioning

confidence: 99%

“…In relation to practitioner performance, the studies reported improved turnaround time for first dose of antibiotic, improved selection of antibiotics (e.g. in line with local protocols), optimal dosing, improved adherence to guidelines/protocols, and a decrease in the total number of antibiotics prescribed . Some studies also reported a reduction in prescribing errors and increased de‐escalation, as well as improved antibiotic sensitivity and increase in sensitivity of surgical site infection detection .…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Approaches to promoting the appropriate use of antibiotics through hospital electronic prescribing systems: a scoping review

et al. 2016

View full text Add to dashboard Cite

Objective To identify approaches of using stand-alone and more integrated hospital ePrescribing systems to promote and support the appropriate use of antibiotics, and identify gaps in order to inform future efforts in this area. Methods A systematic scoping review of the empirical literature from 1997 until 2015, searching the following databases: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Google Scholar, Clinical Trials, International Standard Randomised Controlled Trial Number Registry, Economic Evaluation database and International Prospective Register of Systematic Reviews. Search terms related to different components of systems, hospital settings and antimicrobial stewardship. Two reviewers independently screened papers and mutually agreed papers for inclusion. We undertook an interpretive synthesis. Key findings We identified 143 papers. The majority of these were single-centre observational studies from North American settings with a wide range of system functionalities. Most evidence related to computerised decision support (CDS) and computerised physician order entry (CPOE) functionalities, of which many were extensively customised. We also found some limited work surrounding integration with laboratory results, pharmacy systems and organisational surveillance. Outcomes examined included healthcare professional performance, patient outcomes and health economic evaluations. We found at times conflicting conclusions surrounding effectiveness, which may be due to heterogeneity of populations, technologies and outcomes studied. Reports of unintended consequences were limited. Conclusions Interventions are centred on CPOE and CDS, but also include additional functionality aiming to support various facets of the medicines management process. Wider organisational dimensions appear important to supporting adoption. Evaluations should consider processes, clinical, economic and safety outcomes in order to generate generalisable insights into safety, effectiveness and cost-effectiveness.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Approaches to promoting the appropriate use of antibiotics through hospital electronic prescribing systems: a scoping review

et al. 2016

View full text Add to dashboard Cite

show abstract

“…studied the impact of an automated dispensing cabinet alert on improving compliance with the core measure of obtaining blood cultures prior to giving antibiotics to patients with pneumonia being admitted to the hospital. Compliance with this measure increased from 84% in the pre‐intervention period to 95% in the post‐intervention period ( P < 0.001) . In a study by Ostrowsky et al ., an antibiotic stewardship team developed a community‐acquired pneumonia treatment algorithm with the goal of improving guideline compliance.…”

Section: Resultsmentioning

confidence: 77%

“…Compliance with this measure increased from 84% in the pre-intervention period to 95% in the post-intervention period (P < 0.001). 15 In a study by Ostrowsky et al, an antibiotic stewardship team developed a communityacquired pneumonia treatment algorithm with the goal of improving guideline compliance. Although the algorithm was posted on paper, they developed a pneumonia treatment kit containing guidelinecompliant antibiotic regimens to be dispersed by an automated dispensing cabinet.…”

Section: Resultsmentioning

confidence: 99%

Community‐acquired pneumonia management and outcomes in the era of health information technology

2017

View full text Add to dashboard Cite

Pneumonia continues to be a leading cause of hospitalization and mortality. Implementation of health information technology (HIT) can lead to cost savings and improved care. In this review, we examine the literature on the use of HIT in the management of community-acquired pneumonia. We also discuss barriers to adoption of technology in managing pneumonia, the reliability and quality of electronic health data in pneumonia research, how technology has assisted pneumonia diagnosis and outcomes research. The goal of using HIT is to develop and deploy generalizable, real-time, computerized clinical decision support integrated into usual pneumonia care. A friendly user interface that does not disrupt efficiency and demonstrates improved clinical outcomes should result in widespread adoption.

show abstract

“…[1] From journals devoted to such diverse areas of medical practice including emergency medicine to medical education, coagulation, quality improvement, and HIV, a continued interest in the appropriateness of laboratory testing has existed from the 1940s to the present day. [234567] Pathologists and others who evaluate laboratory test utilization management, generally echo a common theme of improving patient care and decreasing medical costs. [89101112]…”

Section: Introductionmentioning

confidence: 99%

A bayesian approach to laboratory utilization management

Hauser

Jackson

Shirts

2015

Journal of Pathology Informatics

View full text Add to dashboard Cite

Background:Laboratory utilization management describes a process designed to increase healthcare value by altering requests for laboratory services. A typical approach to monitor and prioritize interventions involves audits of laboratory orders against specific criteria, defined as rule-based laboratory utilization management. This approach has inherent limitations. First, rules are inflexible. They adapt poorly to the ambiguity of medical decision-making. Second, rules judge the context of a decision instead of the patient outcome allowing an order to simultaneously save a life and break a rule. Third, rules can threaten physician autonomy when used in a performance evaluation.Methods:We developed an alternative to rule-based laboratory utilization. The core idea comes from a formula used in epidemiology to estimate disease prevalence. The equation relates four terms: the prevalence of disease, the proportion of positive tests, test sensitivity and test specificity. When applied to a laboratory utilization audit, the formula estimates the prevalence of disease (pretest probability [PTP]) in the patients tested. The comparison of PTPs among different providers, provider groups, or patient cohorts produces an objective evaluation of laboratory requests. We demonstrate the model in a review of tests for enterovirus (EV) meningitis.Results:The model identified subpopulations within the cohort with a low prevalence of disease. These low prevalence groups shared demographic and seasonal factors known to protect against EV meningitis. This suggests too many orders occurred from patients at low risk for EV.Conclusion:We introduce a new method for laboratory utilization management programs to audit laboratory services.

show abstract

Automated Dispensing Cabinet Alert Improves Compliance with Obtaining Blood Cultures Before Antibiotic Administration for Patients Admitted with Pneumonia

Cited by 9 publications

References 11 publications

Approaches to promoting the appropriate use of antibiotics through hospital electronic prescribing systems: a scoping review

Approaches to promoting the appropriate use of antibiotics through hospital electronic prescribing systems: a scoping review

Community‐acquired pneumonia management and outcomes in the era of health information technology

A bayesian approach to laboratory utilization management

Contact Info

Product

Resources

About