Reduction in Use of Anti-Infective Agents and Incidence of Infections After the Introduction of Antimicrobial Stewardship Program and Enhanced infection Prevention Program Supported by a Newly Implemented Decision Support System

2011 ◽  
Vol 39 (5) ◽  
pp. E202
Author(s):  
Richard Scott ◽  
Kim Simon ◽  
Nasir Ahmad ◽  
Salah Qutaishat ◽  
Viktoriya Fridman ◽  
...  
Keyword(s):  
Decision Support ◽  
Decision Support System ◽  
Antimicrobial Stewardship ◽  
Support System ◽  
Prevention Program ◽  
Infection Prevention ◽  
Antimicrobial Stewardship Program ◽  
Stewardship Program

Clinical impact of accepting or rejecting a recommendation from a clinical decision support system–assisted antibiotic stewardship program

2021 ◽  
pp. e20200036
Author(s):  
Esther Nadeau ◽  
Adam Mercier ◽  
Julie Perron ◽  
Mélanie Gilbert ◽  
Vincent Nault ◽  
...  
Keyword(s):  
Decision Support ◽  
Decision Support System ◽  
Clinical Decision Support ◽  
Support System ◽  
Clinical Decision Support System ◽  
Clinical Decision ◽  
Antimicrobial Treatment ◽  
Charlson Comorbidity Index Score ◽  
Individual Patient Level ◽  
Stewardship Program

Background: Outcomes associated with physician responses to recommendations from an antimicrobial stewardship program (ASP) at an individual patient level have not yet been assessed. We aimed to compare clinical characteristics and mortality risk among patients for whom recommendations from an ASP were accepted or refused. Methods: A prospective cohort study was performed with hospitalized adults who received intravenous or oral antimicrobials at a 677-bed academic centre in Canada in 2014–2017. We included patients with an alert produced by a clinical decision support system (CDSS) for whom a recommendation was made by the pharmacist to the attending physician. The outcome was 90-day in-hospital all-cause mortality. Results: We identified 3,197 recommendations throughout the study period, of which 2,885 (90.2%) were accepted. The median length of antimicrobial treatment was significantly shorter when a recommendation was accepted (0.26 versus 1.78 days; p < 0.001). Refusal of a recommendation was not associated with mortality (odds ratio 1.32; 95% confidence interval, 0.93 to 1.89; p = 0.12). The independent risk factors associated with in-hospital mortality were age, Charlson Comorbidity Index score, admission to a critical care unit, duration between admission and recommendation, and issuance of a recommendation on a carbapenem. Conclusions: The duration of antimicrobial treatment was significantly shorter when a recommendation originating from a CDSS-assisted ASP program was accepted. Future prospective studies including potential residual confounding variables, such as the source of infection or physiological derangement, might help in understanding whether CDSS-assisted ASP will have a direct impact on patient mortality.

Guidance DS: A web-based clinical decision support system for antimicrobial stewardship in hospitals

2009 ◽  
Vol 42 (12) ◽  
pp. 354-358
Author(s):  
Karin Thursky ◽  
Marion Robertson ◽  
Susan Luu ◽  
James Black ◽  
Michael Richards ◽  
...  
Keyword(s):  
Decision Support ◽  
Decision Support System ◽  
Clinical Decision Support ◽  
Antimicrobial Stewardship ◽  
Support System ◽  
Clinical Decision Support System ◽  
Clinical Decision ◽  
Web Based

Effective use of a clinical decision-support system to advance antimicrobial stewardship

2012 ◽  
Vol 69 (18) ◽  
pp. 1543-1544 ◽  
Author(s):  
Jean Patel ◽  
John S. Esterly ◽  
Marc H. Scheetz ◽  
Maureen K. Bolon ◽  
Michael J. Postelnick
Keyword(s):  
Decision Support ◽  
Decision Support System ◽  
Clinical Decision Support ◽  
Antimicrobial Stewardship ◽  
Support System ◽  
Clinical Decision Support System ◽  
Clinical Decision ◽  
Effective Use
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