A Pharmacy-Based Electronic Handoff Tool to Reduce Discharge Prescribing of Atypical Antipsychotics Initiated in the Intensive Care Unit: A Quality Improvement Initiative.
| Autor: | Kram, Bridgette L., Schultheis, Jennifer M., Kram, Shawn J., Cox, Christopher E. |
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| Předmět: |
ANTIPSYCHOTIC agents
ACADEMIC medical centers COMMUNICATION CONFIDENCE intervals DRUGS HOSPITAL care INTENSIVE care units MEDICAL care MULTIVARIATE analysis PHARMACISTS QUALITY assurance LOGISTIC regression analysis DISCHARGE planning CRITICALLY ill patient psychology ELECTRONIC health records ATTITUDES of medical personnel INAPPROPRIATE prescribing (Medicine) ODDS ratio |
| Zdroj: | Journal of Pharmacy Practice; Aug2019, Vol. 32 Issue 4, p434-441, 8p |
| Abstrakt: | Purpose: To evaluate whether a pharmacist-initiated electronic handoff tool can reduce the overall, and potentially inappropriate, hospital discharge prescribing rate of atypical antipsychotics (AAP) initiated in AAP-naive critically ill adults. Methods: This pre–post quality improvement study was initiated in 5 intensive care units (ICUs) at a large academic medical center. An electronic handoff tool (iVent) was utilized in the post-intervention period to enhance pharmacist communication at inpatient transitions of care. Results: Of the 358 included patients, the proportion of hospital survivors with an AAP initiated in the ICU receiving a hospital discharge prescription was not different between the pre- and post-intervention period (28.6% vs 22.2%, P =.12). The proportion of ICU survivors with an AAP continued at the time of ICU transfer to the floor was reduced post-intervention (78.7% vs 66.7%, P =.012). Additionally, the overall proportion of a patient's hospitalization receiving an AAP was also reduced (50.4% vs 42.8%, P =.008). A multivariate logistic regression demonstrated thatutilization of the electronic handoff tool was not associated with a reduction in hospital discharge prescribing of an AAP (odds ratio [OR]: 0.97, 95% confidence interval [CI]: 0.57-1.65). Conclusions: A pharmacy-initiated electronic handoff tool may reduce the proportion of AAP-naive ICU survivors with an AAP continued at the time of ICU transfer. The handoff tool was not associated with a significant reduction in the discharge prescribing rates of AAPs for hospital survivors, but a clinically meaningful reduction was possibly achieved due to enhanced communication enabled by this tool. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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