1009. Capturing outcomes of targeted antibiotic stewardship (AS) education to clinical pharmacists (CPs) though the creation of a customized electronic documentation form
Session: Poster Abstract Session: Antibiotic Stewardship: General Acute Care Implementation and Outcomes
Friday, October 28, 2016
Room: Poster Hall
Posters
  • Final - IDWeek2016 Poster-Dorobisz ASP Education Outcomes 2.pdf (520.8 kB)
  • Background: Education is a core element used in AS programs (ASPs).  Few examples exist in the literature on how to capture outcomes of targeted AS education strategies.

    Methods:  The infectious diseases (ID) pharmacist began targeted education with CPs at a 359 bed community teaching hospital in 2011 including didactic lectures, competency exams and individual case help on topics such as ID guidelines, shortening durations, de-escalation, pharmacokinetic/ pharmacodynamic (PK/PD) dosing and procalcitonin testing. In addition, a vancomycin monitoring service conducted by all pharmacists on all shifts was implemented in 2013 after completing extensive PK education.  Prior to 2015, CPs used a general Cerner® pharmacy intervention form to document recommendations made to providers.  In 2015 a new form was customized with options for documenting interventions specific to AS activities targeted through education (Figure 1); a new Cerner® report was written to capture the data.  CP antibiotic-related interventions (ARIs) from the 2010 year were compared to the 2015 year to determine if education increased the number and quality of ARIs.

    Description: Description: Description: Description: H:\ASP interventions\IDWeek 2016 Abstract- pharmacist asp interventions - FINAL_files\image001.jpg

    Results:  The number of ARIs increased by 55% from 2,511 pre-education (3% not accepted by providers) to 3,900 post-education (1% not accepted).  Lower level ARIs (optimize monitoring, IV to PO, order/allergy clarification, lab recommendations and other) decreased from 1,061 in 2010 to 407 in 2015.  Higher-level ARIs increased from 2010 to 2015.  PK/PD and renal dose adjustments increased by 5.4-fold from 374 to 2,011, and ARIs involving discontinuation/shortening durations increased by 77% from 356 to 631, respectively.  Initial antibiotic selection, escalation and de-escalation were previously captured under a “therapeutic recommendations” category and increased by 65% from 388 (2010) to 639 (2015) ARIs.

    Conclusion: A customized ASP intervention form for electronic documentation of CP ASP activities can capture outcomes of targeted education strategies and serve as a quality control mechanism for ARIs.  The increase in number, acceptance and quality of ARIs demonstrates that clinical pharmacists can play a vital role in furthering the reach of ASP interventions with directed education from ID specialists. 

     

    Monica Dorobisz, PharmD, Ronald Zangari, RPh and Michelle Kelley, PharmD, Pharmacy, Kent Hospital, Warwick, RI

    Disclosures:

    M. Dorobisz, None

    R. Zangari, None

    M. Kelley, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.