1858. Use and Perceptions of an Institution-Specific Antibiotic Prescribing “App” among Emergency Department and Urgent Care Clinicians

BACKGROUND: We developed an application (app), accessible by mobile device or computer, to provide institution-specific antibiotic prescribing recommendations for common infections. The app was disseminated to emergency department (ED) and urgent care clinicians in August 2014. The purpose of this study was to assess current use of the app and its perceived impact on prescribing. METHODS: We developed and administered an online survey. The survey instrument was pre-tested by a survey methodologist, two emergency medicine physicians, an infectious diseases (ID) physician, and an ID pharmacist and subsequently pilot-tested in a group of 70 providers. The final survey was administered to all clinicians in the Denver Health ED and two urgent care centers, including physicians, advanced practice providers, and Emergency Medicine residents. Respondents were eligible if they had worked at least one ED or urgent care shift within 90 days and either personally prescribe antibiotics or oversee other clinicians who prescribe antibiotics. RESULTS: Of 156 clinicians, 99 responded, of whom 93 were eligible, for a response rate of 65%. Eligible respondents included 38 attending physicians, 18 advanced practice providers, and 37 residents. 91 (98%) had ever used the antibiotic app, and of those, 84 (93%) considered themselves to be regular users. 85% of users primarily accessed the app by smartphone. Mean (standard deviation [SD]) reported use was 3.0 (2.3) episodes per shift. 85% of users reported the app to be very useful (range: not at all useful to very useful). Among users of common prescribing resources including UpToDate™, Sanford Guide™, EMRA Guide to Antibiotics™, and the Johns Hopkins Guide to Antibiotics™, the institutional app had the highest reported usefulness. The mean (SD) perceived effect on accuracy of antibiotic choice, accuracy of dosing, consistency of prescribing, and effect on decreasing durations of therapy was 4.5 (0.5), 4.50 (0.6), 4.4 (0.7), and 3.5 (0.7), respectively (range: 1–5, with higher scores indicating greater effect). CONCLUSION: Among ED and urgent care clinicians, an institution-specific antibiotic app was widely utilized and perceived to be a useful clinical resource that impacted prescribing. Institution-specific apps may be effective tools to promote uptake of local prescribing guidance. DISCLOSURES: All authors: No reported disclosures.