Vancomycin Control Measures at a Tertiary-Care Hospital: Impact of Interventions on Volume and Patterns of Use
| Autor: | Rachel F. Haft, Amy Shafer, Kenneth Sands, Tamar F. Barlam, Mark D. Aronson, Mary Singer |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty Epidemiology Hospital Bed Capacity 300 to 499 Psychological intervention MEDLINE Hospitals General Drug Utilization Review Vancomycin Medical Staff Hospital medicine Humans Medical prescription Hospital pharmacy Intensive care medicine Antibacterial agent business.industry Medical record biochemical phenomena metabolism and nutrition Anti-Bacterial Agents Logistic Models Infectious Diseases Practice Guidelines as Topic Guideline Adherence business Algorithms Boston medicine.drug |
| Zdroj: | Infection Control and Hospital Epidemiology. 19:248-253 |
| ISSN: | 1559-6834 0899-823X |
| DOI: | 10.1086/647803 |
| Popis: | OBJECTIVE: Evaluate vancomycin prescribing patterns in a tertiary-care hospital before and after interventions to decrease vancomycin utilization.DESIGN: Before/after analysis of interventions to limit vancomycin use.SETTING: 420-bed academic tertiary-care center.INTERVENTIONS: Educational efforts began August 10, 1994, and involved lectures to medical house staff followed by mailings to all physicians and posting of guidelines for vancomycin use on hospital information systems. Active interventions began November 15, 1994, and included automatic stop orders for vancomycin at 72 hours, alerts attached to the medical record, and, for 2 weeks only, computer alerts to physicians following each vancomycin order. Parenteral vancomycin use was estimated from the hospital pharmacy database of all medication orders. Records of a random sample of 344 patients receiving van-comycin between May 1, 1994, and April 30, 1995, were reviewed for an indication meeting published guidelines.RESULTS: Vancomycin prescribing decreased by 22% following interventions, from 8.5 to 6.8 courses per 100 discharges (PCONCLUSIONS: Parenteral vancomycin prescribing decreased significantly following interventions, but the majority of orders still were not for an indication meeting published guidelines. Further improvement in the appropriateness of vancomycin prescribing potentially could be accomplished by more aggressive interventions, such as computer alerts, or by targeting specific aspects of prescribing patterns. |
| Databáze: | OpenAIRE |
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