Improved rates of antimicrobial stewardship interventions following implementation of the Epic antimicrobial stewardship module

Pettit, Natasha N; Han, Zhe; Choksi, Anish; Charnot-Katsikas, Angella; Beavis, Kathleen G.; Tešić, Vera; Bhagat, Palak; Nguyen, Cynthia T; Bartlett, Allison H.; Pisano, Jennifer

doi:10.1017/ice.2018.130

Cited by 7 publications

(5 citation statements)

References 5 publications

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“…With the advancement of technology and data management systems, it is foreseeable that more sophisticated CDSSs will be developed to serve this very purpose in the near future [ 45 ]. Antibiotic CDSSs have been demonstrated to greatly improve the efficiency of antimicrobial stewardship interventions; similarly, the resource and time constraints that hospital pharmacists face in antimicrobial stewardship activities could be addressed by the same systems [ 46 ]. With the use of CDSSs, simple antimicrobial stewardship workflows can be incorporated, freeing up pharmacists’ time to review complex cases and participate in training and educational activities [ 47 , 48 ].…”

Section: Discussionmentioning

confidence: 99%

Hospital Pharmacists and Antimicrobial Stewardship: A Qualitative Analysis

et al. 2021

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Antimicrobial stewardship programmes (ASPs) in hospitals are predominantly led by specific ASP physicians and pharmacists. Limited studies have been conducted to appreciate non-ASP-trained hospital pharmacists’ perspectives on their roles in antimicrobial stewardship. Focus group discussions (FGDs) were conducted with 74 pharmacists, purposively sampled from the 3 largest acute-care public hospitals in Singapore, to explore facilitators and barriers faced by them in antimicrobial stewardship. Applied thematic analysis was conducted and codes were categorised using the social–ecological model (SEM). At the intrapersonal level, pharmacists identified themselves as reviewers for drug safety before dispensing, confining to a restricted advisory role due to lack of clinical knowledge, experience, and empowerment to contribute actively to physicians’ prescribing decisions. At the interpersonal level, pharmacists expressed difficulties conveying their opinions and recommendations on antibiotic therapy to physicians despite frequent communications, but they assumed critical roles as educators for patients and their caregivers on proper antibiotic use. At the organisational level, in-house antibiotic guidelines supported pharmacists’ antibiotic interventions and recommendations. At the community level, pharmacists were motivated to improve low public awareness and knowledge on antibiotic use and antimicrobial resistance. These findings provide important insights into the gaps to be addressed in order to harness the untapped potential of hospital pharmacists and fully engage them in antimicrobial stewardship.

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Section: Discussionmentioning

confidence: 99%

Hospital Pharmacists and Antimicrobial Stewardship: A Qualitative Analysis

et al. 2021

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“…For example, we made a major effort in the last year to change the way C. difficile is diagnosed and treated at our institution [21]. Interestingly, Pettit et al recently reported a correlation between their use of the Epic Antimicrobial Stewardship Module and an increased number of stewardship interventions, which they also attributed to a streamlined and consistent process for documentation, tracking, and reporting [22]. Thus, our report extends that observation to the Cerner system, while highlighting important underlying principles required for effective documentation and tracking of an ASP.…”

Section: Discussionmentioning

confidence: 99%

Customizing an Electronic Medical Record to Automate the Workflow and Tracking of an Antimicrobial Stewardship Program

Katzman

Kim

Lesher

et al. 2019

Open Forum Infectious Diseases

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Background Documenting the actions and effects of an antimicrobial stewardship program (ASP) is essential for quality improvement and support by hospital leadership. Thus, our ASP tallies the number of charts reviewed, types of recommendations, how and to whom they were communicated, whether they were followed, and any effects on antimicrobial days of therapy. Here we describe how we customized the electronic medical record at our institution to facilitate our workflow and data analysis, while highlighting principles that should be adaptable to other ASPs. Methods The documentation system involves the creation of a novel and intuitive ASP form in each chart reviewed and 2 mutually exclusive tracking systems: 1 for active forms to facilitate the daily ASP workflow and 1 for finalized forms to generate cumulative reports. The ASP form is created by the ASP pharmacist, edited by the ASP physician, reopened by the pharmacist to assess whether the recommendation was followed and to quantify any antimicrobial days avoided or added, then reviewed and finalized by the ASP physician. Active forms are visible on a real-time “MPage,” whereas all finalized forms are compiled nightly into 65 informative tables and associated graphs. Results and Conclusions This system and its underlying principles have automated much of the documentation, facilitated follow-up of interventions, improved the completeness and validity of recorded data and analysis, enabled our ASP to expand its activities, and been associated with decreased antimicrobial usage, drug resistance, and Clostridioides difficile infections.

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“…Pettit and colleagues utilized the EPIC module with the dynamic scoring system to alert the stewardship team to restricted antimicrobial orders, Staphylococcus aureus bacteremia, fungemia, and other clinically important events. Use of this module resulted in a significant improvement in time to appropriate therapy for bloodstream infections [11,12]. Harvin and colleagues also demonstrated the significant reduction in time to intervention from 24 to 8 h with the use of their scoring tool [13].…”

Section: Emr Stewardship Modulesmentioning

confidence: 98%