دورية أكاديمية
Outcomes of an electronic medical record (EMR)-driven intensive care unit (ICU)-antimicrobial stewardship (AMS) ward round: Assessing the "Five Moments of Antimicrobial Prescribing".
| العنوان: | Outcomes of an electronic medical record (EMR)-driven intensive care unit (ICU)-antimicrobial stewardship (AMS) ward round: Assessing the "Five Moments of Antimicrobial Prescribing". |
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| المؤلفون: | Devchand M; Department of Infectious Diseases, Austin Health, Heidelberg, VIC, Australia.; Pharmacy Department, Austin Health, Heidelberg, VIC, Australia., Stewardson AJ; Department of Infectious Diseases, The Alfred Hospital, VIC, Australia.; Central Clinical School, Monash University, Australia., Urbancic KF; Department of Infectious Diseases, Austin Health, Heidelberg, VIC, Australia.; Pharmacy Department, Austin Health, Heidelberg, VIC, Australia.; The National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, VIC, Australia., Khumra S; Department of Infectious Diseases, Austin Health, Heidelberg, VIC, Australia.; Pharmacy Department, Austin Health, Heidelberg, VIC, Australia., Mahony AA; Department of Infectious Diseases, Austin Health, Heidelberg, VIC, Australia., Walker S; Department of Infectious Diseases, Austin Health, Heidelberg, VIC, Australia.; Pharmacy Department, Austin Health, Heidelberg, VIC, Australia., Garrett K; Pharmacy Department, Austin Health, Heidelberg, VIC, Australia., Grayson ML; Department of Infectious Diseases, Austin Health, Heidelberg, VIC, Australia.; Department of Medicine (Austin Health), University of Melbourne, Parkville, VIC, Australia., Trubiano JA; Department of Infectious Diseases, Austin Health, Heidelberg, VIC, Australia.; The National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, VIC, Australia.; Department of Medicine (Austin Health), University of Melbourne, Parkville, VIC, Australia. |
| المصدر: | Infection control and hospital epidemiology [Infect Control Hosp Epidemiol] 2019 Oct; Vol. 40 (10), pp. 1170-1175. Date of Electronic Publication: 2019 Aug 13. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Cambridge University Press Country of Publication: United States NLM ID: 8804099 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1559-6834 (Electronic) Linking ISSN: 0899823X NLM ISO Abbreviation: Infect Control Hosp Epidemiol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Jan. 2015- : Cambridge : Cambridge University Press Original Publication: [Thorofare, N.J. ] : SLACK Inc., c1988- |
| مواضيع طبية MeSH: | Electronic Health Records* , Intensive Care Units*, Antimicrobial Stewardship/*standards , Practice Patterns, Physicians'/*statistics & numerical data, Anti-Infective Agents/therapeutic use ; Australia ; Humans ; Program Evaluation ; Prospective Studies |
| مستخلص: | Objective: The primary objective of this study was to examine the impact of an electronic medical record (EMR)-driven intensive care unit (ICU) antimicrobial stewardship (AMS) service on clinician compliance with face-to-face AMS recommendations. AMS recommendations were defined by an internally developed "5 Moments of Antimicrobial Prescribing" metric: (1) escalation, (2) de-escalation, (3) discontinuation, (4) switch, and (5) optimization. The secondary objectives included measuring the impact of this service on (1) antibiotic appropriateness, and (2) use of high-priority target antimicrobials. Methods: A prospective review was undertaken of the implementation and compliance with a new ICU-AMS service that utilized EMR data coupled with face-to-face recommendations. Additional patient data were collected when an AMS recommendation was made. The impact of the ICU-AMS round on antimicrobial appropriateness was evaluated using point-prevalence survey data. Results: For the 202 patients, 412 recommendations were made in accordance with the "5 Moments" metric. The most common recommendation made by the ICU-AMS team was moment 3 (discontinuation), which comprised 173 of 412 recommendations (42.0%), with an acceptance rate of 83.8% (145 of 173). Data collected for point-prevalence surveys showed an increase in prescribing appropriateness from 21 of 45 (46.7%) preintervention (October 2016) to 30 of 39 (76.9%) during the study period (September 2017). Conclusions: The integration of EMR with an ICU-AMS program allowed us to implement a new AMS service, which was associated with high clinician compliance with recommendations and improved antibiotic appropriateness. Our "5 Moments of Antimicrobial Prescribing" metric provides a framework for measuring AMS recommendation compliance. |
| المشرفين على المادة: | 0 (Anti-Infective Agents) |
| تواريخ الأحداث: | Date Created: 20190814 Date Completed: 20200529 Latest Revision: 20200529 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1017/ice.2019.218 |
| PMID: | 31407651 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1559-6834 |
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| DOI: | 10.1017/ice.2019.218 |