Reduction of Incorrect Antibiotic Dosing Through a Structured Educational Order Form

Avorn, Jerry

doi:10.1001/archinte.1988.00380080024009

Cited by 97 publications

(24 citation statements)

References 23 publications

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“…19 The form contained several educational messages about appropriate antibiotic use, includ ing a reminder that cefazolin should be given no more frequently than every eight hours; howeve no particular mention was made of the periopera tive use of antibiotics.…”

Section: Methodsmentioning

confidence: 99%

Changing Surgical Antimicrobial Prophylaxis Practices through Education Targeted at Senior Department Leaders

Everitt¹,

Soumerai²,

Avorn³

et al. 1990

Infection Control and Hospital Epidemiology

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Prescribing antibiotics for perioperative prophylaxis in common surgical procedures presents an ideal target for educational intervention. In this situation, antibiotics are often used inappropriately, with consequent excess expense and risk of morbidity. We developed an educational intervention aimed at the choice and appropriate dosing of antibiotics for the prophylaxis of cesarean sections. Person-to-person educational messages targeted at authoritative senior department members were supplemented by brief reminders on a structured antibiotic order form. Time-series analyses were conducted on 34 months of antibiotic use data for 2,783 cesarean sections to estimate the trend of magnitude and significance of discontinuities associated with the start of the program.Prior to the intervention, 95% of sections receiving prophylaxis were given cefoxitin and 3% were given cefazolin. After the intervention, these proportions were reversed, with the shift in use occurring immediately after the intervention (p<.001). Two years after the intervention, virtually all patients undergoing cesarean sections who receive antibiotic prophylaxis are given cefazolin. Savings from this change alone accounted for over $26,000 each year, or $47.36 per patientday of prophylaxis. Substantial changes in prescribing practices for routine procedures can be accomplished through the implementation of a coordinated educational program that enlists influential senior staff members in a department in which policy-making is highly centralized, coupled with a structured educational ordering system. Lasting improvements in clinical practices may be brought about by means that are noncoercive, inexpensive and well-accepted by medical staff. (Infect Control Hosp Epidemiol. 1990;11:578-583.)

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Section: Methodsmentioning

confidence: 99%

Changing Surgical Antimicrobial Prophylaxis Practices through Education Targeted at Senior Department Leaders

Everitt¹,

Soumerai²,

Avorn³

et al. 1990

Infection Control and Hospital Epidemiology

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“…Education as the sole intervention strategy to improve quality has not always been successful (7). Antibiotic order forms filled in by prescribes have been used to monitor use and to influence prescribing habits in the USA (8,9), but experience in Europe is very limited or unpub lished.…”

mentioning

confidence: 99%

Implementation of an educational program and an antibiotic order form to optimize quality of antimicrobial drug use in a department of internal medicine

Gyssens

Blok

Broek

et al. 1997

Eur. J. Clin. Microbiol. Infect. Dis.

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“…Similar positive impacts of narratives were seen in the experience of Avorn et al with inpatient antibiotics. 5 Finally, we provided detailed nursing instructions to monitor urine output, redose with diuretics, and maximize nitroglycerin titration. Nursing was reluctant to push these medications, but this effort was aided by the addition of our pharmacist.…”

Section: Discussionmentioning

confidence: 99%

“…4 They have been routinely used as part of CPG implementation, but little research has established their unique utility. [5][6][7] Order sets in emergency medicine have been reported as part of general quality improvement projects [8][9][10] and numerous emergency medical services (EMS)-related efforts. [11][12][13] Exclusive evaluation of written standing orders within the emergency department (ED) has been limited to use of preprinted order sheets that successfully improved management of septic shock 7 and reduced pediatric medication errors.…”

mentioning

confidence: 99%

Impact of Human Factor Design on the Use of Order Sets in the Treatment of Congestive Heart Failure

Reingold¹,

Kulstad²

2007

Academic Emergency Medicine

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Reduction of Incorrect Antibiotic Dosing Through a Structured Educational Order Form

Cited by 97 publications

References 23 publications

Changing Surgical Antimicrobial Prophylaxis Practices through Education Targeted at Senior Department Leaders

Changing Surgical Antimicrobial Prophylaxis Practices through Education Targeted at Senior Department Leaders

Implementation of an educational program and an antibiotic order form to optimize quality of antimicrobial drug use in a department of internal medicine

Impact of Human Factor Design on the Use of Order Sets in the Treatment of Congestive Heart Failure

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