A Multidisciplinary Quality Improvement Initiative to Facilitate Penicillin Allergy Delabeling Among Hospitalized Pediatric Patients
| Autor: | Maureen Egan Bauer, Christine E. MacBrayne, Tara Sarin, Cheryl Yang, Hannah Duffey, Michael Rannie, Justin B Searns, Allison Hicks, Lalit Bajaj, Kirstin Carel, Amy Stein, Taylor Lin, Kaylee Wickstrom |
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| Rok vydání: | 2021 |
| Předmět: |
Methicillin-Resistant Staphylococcus aureus
Allergy medicine.medical_specialty medicine.drug_class Antibiotics Population Psychological intervention Penicillins Pediatrics Drug Hypersensitivity 03 medical and health sciences 0302 clinical medicine Clinical pathway 030225 pediatrics Medicine Humans 030212 general & internal medicine Adverse effect education Child education.field_of_study business.industry General Medicine medicine.disease Quality Improvement Hospital medicine Anti-Bacterial Agents Penicillin Pediatrics Perinatology and Child Health Emergency medicine business medicine.drug |
| Zdroj: | Hospital pediatrics. 11(5) |
| ISSN: | 2154-1671 |
| Popis: | BACKGROUND: Penicillin allergy is reported in up to 10% of the general population; however, >90% of patients reporting an allergy are tolerant. Patients labeled as penicillin allergic have longer hospital stays, increased exposure to suboptimal antibiotics, and an increased risk of methicillin-resistant Staphylococcus aureus and Clostridioides difficile. The primary aim with our quality improvement initiative was to increase penicillin allergy delabeling to at least 10% among all hospitalized pediatric patients reporting a penicillin allergy with efforts directed toward patients determined to be low risk for true allergic reaction. METHODS: Our quality improvement project included several interventions: the development of a multidisciplinary clinical care pathway to identify eligible patients, workflow optimization to support delabeling, an educational intervention, and participation in our institution’s quality improvement incentive program. Our interventions were targeted to facilitate appropriate delabeling by the primary hospital medicine team. Statistical process control charts were used to assess the impact of this intervention pre- and postpathway implementation. RESULTS: After implementation of the clinical pathway, the percentage of patients admitted to hospital medicine delabeled of their penicillin allergy by discharge increased to 11.7%. More than one-half of those delabeled (51.2%) received a penicillin-based antimicrobial at time of discharge. There have been no adverse events or allergic reactions requiring emergency medication administration since pathway implementation. CONCLUSIONS: Our quality improvement initiative successfully increased the rate of penicillin allergy delabeling among low-risk hospitalized pediatric patients, allowing for increased use of optimal antibiotics. |
| Databáze: | OpenAIRE |
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