Centralized Communication of Blood Culture Results Leveraging Antimicrobial Stewardship and Rapid Diagnostics

Autor:	Andrew Warnes, Kevin F. Kennedy, Donna M. Buchanan, Shelby Shemanski, Cynthia Essmyer, Sarah Boyd, Nicholas Bennett
Rok vydání:	2019
Předmět:	0301 basic medicine medicine.medical_specialty medicine.diagnostic_test business.industry Hospitalized patients 030106 microbiology Pharmacy Patient specific rapid diagnostics Major Articles 03 medical and health sciences antimicrobial stewardship 0302 clinical medicine Infectious Diseases Oncology Physician survey Intervention (counseling) Emergency medicine medicine Antimicrobial stewardship Blood culture In patient 030212 general & internal medicine business
Zdroj:	Open Forum Infectious Diseases
ISSN:	2328-8957
Popis:	Objective This study aimed to determine if integrating antimicrobial stewardship program (ASP) personnel with rapid diagnostic testing resulted in improved outcomes for patients with positive blood cultures. Method Beginning in 2016, Saint Luke’s Health System (SLHS) implemented a new process where all positive blood cultures were communicated to ASP personnel or SLHS pharmacy staff. Pharmacists then became responsible for interpreting results, assessing patient specific information, and subsequently relaying culture and treatment information to providers. This was a multisite, pre-post, quasi-experimental study (Pre: August to December 2014; Post: August to December 2016). Patients 18 years of age and older with a positive blood culture during admission were included (2014, n = 218; 2016, n = 286). Coprimary outcomes of time to optimal and appropriate therapy were determined from time of culture positivity via gram stain. Secondary outcomes focused on clinical, process, and fiscal endpoints. A pre-post intervention physician survey was conducted to assess the impact on antimicrobial decision making and perceived effect on patient outcomes. Results There was no difference in time to appropriate therapy groups (P = .079). Time to optimal therapy was 9.2 hours shorter in 2016 (P = .004). Provider surveys indicated the process improved communication among clinicians and facilitated a shared decision-making process with a perceived improvement in patient care. Conclusions An ASP-led blood culture communication process for patients with positive blood cultures was shown to improve time to optimal therapy, support physicians in their decision making on critical lab data, and improve the care for hospitalized patients. Integration of antimicrobial stewardship personnel plus rapid identification testing was associated with reduced time to optimal therapy, increased collaboration between clinical staff, and improved care for hospitalized patients with positive blood cultures.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8b57c803826cb19500ca75fd3adc93f6 https://pubmed.ncbi.nlm.nih.gov/31660401 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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