Development and implementation of "handshake rounds": An antibiotic stewardship intervention for hospitalized adult patients with hematologic malignancies.

Autor:	Gorsline CA; Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.; Division of Infectious Diseases, Department of Medicine, University of Kansas Medical Center, Kansas City, Kansas., Miller RM; Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, Tennessee., Bobbitt LJ; Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, Tennessee., Satyanarayana G; Northside Hospital, Atlanta, Georgia., Baljevic M; Division of Hematology and Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee., Staub MBO; Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
Jazyk:	angličtina
Zdroj:	Antimicrobial stewardship & healthcare epidemiology : ASHE [Antimicrob Steward Healthc Epidemiol] 2023 Apr 17; Vol. 3 (1), pp. e76. Date of Electronic Publication: 2023 Apr 17 (Print Publication: 2023).
DOI:	10.1017/ash.2023.125
Abstrakt:	Objective: To design and implement "handshake rounds" as an antibiotic stewardship intervention to reduce inpatient intravenous (IV) antibiotic use in patients with hematologic malignancies. Design: Quasi-experimental analysis of antibiotic use (AU) and secondary outcomes before and and after handshake rounds were implemented. Setting: Quaternary-care, academic medical center. Patients: Hospitalized adults with hematologic malignancies receiving IV antibiotics. Methods: We performed a retrospective review of a preintervention cohort prior to the intervention. A multidisciplinary team developed criteria for de-escalation of antibiotics, logistics of handshake rounds, and outcome metrics. Eligible patients were discussed during scheduled handshake rounds between a hematology-oncology pharmacist and transplant-infectious diseases (TID) physician. Prospective data were collected over 30 days in the postintervention cohort. Due to small sample size, 2:1 matching was used to compare pre- to and postintervention AU. Total AU in days of therapy per 1,000 patient days (DOT/1,000 PD) was reported. Mean AU per patient was analyzed using Wilcoxon rank-sum test. A descriptive analysis of secondary outcomes of pre- and postintervention cohorts was performed. Results: Total AU was substantially lower after the intervention, with 517 DOT/1,000 PD compared to 865 DOT/1,000 PD before the intervention. There was no statistically significant difference in the mean AU per patient between the 2 cohorts. There was a lower rate of 30-day mortality in the postintervention cohort and rates of ICU admissions were similar. Conclusions: Conducting handshake rounds is a safe and effective way to implement an antibiotic stewardship intervention among high-risk patient population such as those with hematologic malignancies. Competing Interests: All authors report no conflicts of interest relevant to this article. (© The Author(s) 2023.)
Databáze:	MEDLINE
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