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Pharmacist-Driven Culture and Sexually Transmitted Infection Testing Follow-Up Program in the Emergency Department

Expanding pharmacist-driven antimicrobial stewardship efforts in the emergency department (ED) can improve antibiotic management for both admitted and discharged patients. We piloted a pharmacist-driven culture and rapid diagnostic technology (RDT) follow-up program in patients discharged from the E...

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Autores principales: Shealy, Stephanie C., Alexander, Christine, Hardison, Tina Grof, Magagnoli, Joseph, Justo, Julie Ann, Derrick, Caroline, Kohn, Joseph, Winders, Hana Rac, Privette, Troy, Al-Hasan, Majdi N., Bookstaver, P. Brandon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7356047/
https://www.ncbi.nlm.nih.gov/pubmed/32340149
http://dx.doi.org/10.3390/pharmacy8020072
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author Shealy, Stephanie C.
Alexander, Christine
Hardison, Tina Grof
Magagnoli, Joseph
Justo, Julie Ann
Derrick, Caroline
Kohn, Joseph
Winders, Hana Rac
Privette, Troy
Al-Hasan, Majdi N.
Bookstaver, P. Brandon
author_facet Shealy, Stephanie C.
Alexander, Christine
Hardison, Tina Grof
Magagnoli, Joseph
Justo, Julie Ann
Derrick, Caroline
Kohn, Joseph
Winders, Hana Rac
Privette, Troy
Al-Hasan, Majdi N.
Bookstaver, P. Brandon
author_sort Shealy, Stephanie C.
collection PubMed
description Expanding pharmacist-driven antimicrobial stewardship efforts in the emergency department (ED) can improve antibiotic management for both admitted and discharged patients. We piloted a pharmacist-driven culture and rapid diagnostic technology (RDT) follow-up program in patients discharged from the ED. This was a single-center, pre- and post-implementation, cohort study examining the impact of a pharmacist-driven culture/RDT follow-up program in the ED. Adult patients discharged from the ED with subsequent positive cultures and/or RDT during the pre- (21 August 2018–18 November 2018) and post-implementation (19 November 2018–15 February 2019) periods were screened for inclusion. The primary endpoints were time from ED discharge to culture/RDT review and completion of follow-up. Secondary endpoints included antimicrobial agent prescribed during outpatient follow-up, repeat ED encounters within 30 days, and hospital admissions within 30 days. Baseline characteristics were analyzed using descriptive statistics. Time-to-event data were analyzed using the Wilcoxon signed-rank test. One-hundred-and-twenty-seven patients were included, 64 in the pre-implementation group and 63 in the post-implementation group. There was a 36.3% reduction in the meantime to culture/RDT data review in the post-implementation group (75.2 h vs. 47.9 h, p < 0.001). There was a significant reduction in fluoroquinolone prescribing in the post-implementation group (18.1% vs. 5.4%, p = 0.036). The proportion of patients who had a repeat ED encounter or hospital admission within 30 days was not significantly different between the pre- and post-implementation groups (15.6 vs. 19.1%, p = 0.78 and 9.4% vs. 7.9%, p = 1.0, respectively). Introduction of a pharmacist culture and RDT follow-up program in the ED reduced time to data review, time to outpatient intervention and outpatient follow-up of fluoroquinolone prescribing.
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spelling pubmed-73560472020-07-22 Pharmacist-Driven Culture and Sexually Transmitted Infection Testing Follow-Up Program in the Emergency Department Shealy, Stephanie C. Alexander, Christine Hardison, Tina Grof Magagnoli, Joseph Justo, Julie Ann Derrick, Caroline Kohn, Joseph Winders, Hana Rac Privette, Troy Al-Hasan, Majdi N. Bookstaver, P. Brandon Pharmacy (Basel) Article Expanding pharmacist-driven antimicrobial stewardship efforts in the emergency department (ED) can improve antibiotic management for both admitted and discharged patients. We piloted a pharmacist-driven culture and rapid diagnostic technology (RDT) follow-up program in patients discharged from the ED. This was a single-center, pre- and post-implementation, cohort study examining the impact of a pharmacist-driven culture/RDT follow-up program in the ED. Adult patients discharged from the ED with subsequent positive cultures and/or RDT during the pre- (21 August 2018–18 November 2018) and post-implementation (19 November 2018–15 February 2019) periods were screened for inclusion. The primary endpoints were time from ED discharge to culture/RDT review and completion of follow-up. Secondary endpoints included antimicrobial agent prescribed during outpatient follow-up, repeat ED encounters within 30 days, and hospital admissions within 30 days. Baseline characteristics were analyzed using descriptive statistics. Time-to-event data were analyzed using the Wilcoxon signed-rank test. One-hundred-and-twenty-seven patients were included, 64 in the pre-implementation group and 63 in the post-implementation group. There was a 36.3% reduction in the meantime to culture/RDT data review in the post-implementation group (75.2 h vs. 47.9 h, p < 0.001). There was a significant reduction in fluoroquinolone prescribing in the post-implementation group (18.1% vs. 5.4%, p = 0.036). The proportion of patients who had a repeat ED encounter or hospital admission within 30 days was not significantly different between the pre- and post-implementation groups (15.6 vs. 19.1%, p = 0.78 and 9.4% vs. 7.9%, p = 1.0, respectively). Introduction of a pharmacist culture and RDT follow-up program in the ED reduced time to data review, time to outpatient intervention and outpatient follow-up of fluoroquinolone prescribing. MDPI 2020-04-23 /pmc/articles/PMC7356047/ /pubmed/32340149 http://dx.doi.org/10.3390/pharmacy8020072 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Shealy, Stephanie C.
Alexander, Christine
Hardison, Tina Grof
Magagnoli, Joseph
Justo, Julie Ann
Derrick, Caroline
Kohn, Joseph
Winders, Hana Rac
Privette, Troy
Al-Hasan, Majdi N.
Bookstaver, P. Brandon
Pharmacist-Driven Culture and Sexually Transmitted Infection Testing Follow-Up Program in the Emergency Department
title Pharmacist-Driven Culture and Sexually Transmitted Infection Testing Follow-Up Program in the Emergency Department
title_full Pharmacist-Driven Culture and Sexually Transmitted Infection Testing Follow-Up Program in the Emergency Department
title_fullStr Pharmacist-Driven Culture and Sexually Transmitted Infection Testing Follow-Up Program in the Emergency Department
title_full_unstemmed Pharmacist-Driven Culture and Sexually Transmitted Infection Testing Follow-Up Program in the Emergency Department
title_short Pharmacist-Driven Culture and Sexually Transmitted Infection Testing Follow-Up Program in the Emergency Department
title_sort pharmacist-driven culture and sexually transmitted infection testing follow-up program in the emergency department
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7356047/
https://www.ncbi.nlm.nih.gov/pubmed/32340149
http://dx.doi.org/10.3390/pharmacy8020072
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