scholarly journals Repurposing antimicrobial stewardship tools in the electronic medical record for the management of COVID-19 patients

2020 ◽  
Vol 41 (11) ◽  
pp. 1335-1337 ◽  
Author(s):  
Matthew W. Davis ◽  
Dayna McManus ◽  
Alan Koff ◽  
Gregory R. Jaszczur ◽  
Maricar Malinis ◽  
...  
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Antimicrobial Stewardship

AbstractDuring the COVID-19 pandemic, the antimicrobial stewardship module in our electronic medical record was reconfigured for the management of COVID-19 patients. This change allowed our subspecialist providers to review charts quickly to optimize potential therapy and management during the patient surge.

scholarly journals Survey of Infection Prevention Informatics Use and Practitioner Satisfaction in US Hospitals

2014 ◽  
Vol 35 (7) ◽  
pp. 891-893 ◽  
Author(s):  
Max Masnick ◽  
Daniel J. Morgan ◽  
Marc-Oliver Wright ◽  
Michael Y. Lin ◽  
Lisa Pineles ◽  
...  
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Antimicrobial Stewardship ◽  
Infection Prevention ◽  
Infect Control Hosp ◽  
Infection Preventionists

We surveyed hospital epidemiologists and infection preventionists on their usage of and satisfaction with infection prevention–specific software supplementing their institution’s electronic medical record. Respondents with supplemental software were more satisfied with their software’s infection prevention and antimicrobial stewardship capabilities than those without. Infection preventionists were more satisfied than hospital epidemiologists.Infect Control Hosp Epidemiol 2014;35(7):891–893

scholarly journals Customizing an Electronic Medical Record to Automate the Workflow and Tracking of an Antimicrobial Stewardship Program

2019 ◽  
Vol 6 (8) ◽  
Author(s):  
Michael Katzman ◽  
Jihye Kim ◽  
Mark D Lesher ◽  
Cory M Hale ◽  
George D McSherry ◽  
...  
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Antimicrobial Stewardship ◽  
Antimicrobial Stewardship Program ◽  
Documentation System ◽  
Clostridioides Difficile ◽  
Hospital Leadership ◽  
Stewardship Program ◽  
Days Of Therapy ◽  
Recorded Data

Abstract Background Documenting the actions and effects of an antimicrobial stewardship program (ASP) is essential for quality improvement and support by hospital leadership. Thus, our ASP tallies the number of charts reviewed, types of recommendations, how and to whom they were communicated, whether they were followed, and any effects on antimicrobial days of therapy. Here we describe how we customized the electronic medical record at our institution to facilitate our workflow and data analysis, while highlighting principles that should be adaptable to other ASPs. Methods The documentation system involves the creation of a novel and intuitive ASP form in each chart reviewed and 2 mutually exclusive tracking systems: 1 for active forms to facilitate the daily ASP workflow and 1 for finalized forms to generate cumulative reports. The ASP form is created by the ASP pharmacist, edited by the ASP physician, reopened by the pharmacist to assess whether the recommendation was followed and to quantify any antimicrobial days avoided or added, then reviewed and finalized by the ASP physician. Active forms are visible on a real-time “MPage,” whereas all finalized forms are compiled nightly into 65 informative tables and associated graphs. Results and Conclusions This system and its underlying principles have automated much of the documentation, facilitated follow-up of interventions, improved the completeness and validity of recorded data and analysis, enabled our ASP to expand its activities, and been associated with decreased antimicrobial usage, drug resistance, and Clostridioides difficile infections.

scholarly journals Use of an electronic medical record system to improve antimicrobial stewardship

Critical Care ◽  
2015 ◽  
Vol 19 (Suppl 1) ◽  
pp. P109
Author(s):  
P Allan ◽  
M Newman ◽  
J Collinson ◽  
L Bond ◽  
W English
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Antimicrobial Stewardship ◽  
Electronic Medical Record System ◽  
Record System ◽  
Medical Record System

The Use of Best Practice Alerts with the Development of an Antimicrobial Stewardship Navigator to Promote Antibiotic De-escalation in the Electronic Medical Record

2013 ◽  
Vol 34 (12) ◽  
pp. 1259-1265 ◽  
Author(s):  
Lucas Schulz ◽  
Kurt Osterby ◽  
Barry Fox
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Antimicrobial Stewardship ◽  
Best Practice ◽  
Decision Support Tool ◽  
Clinical Decision ◽  
Antibiotic Use ◽  
Evidence Based ◽  
Support Tool ◽  
Clinical Decision Support Tool

Objective.Develop a clinical decision support tool comprised of an electronic medical record alert and antimicrobial stewardship navigator to facilitate antimicrobial stewardship.Design.We analyzed alerts targeting antimicrobial de-escalation to assess the effectiveness of the navigator as a stewardship tool. The alert provides antimicrobial recommendations, then directs providers to the navigator, which includes order management, relevant patient information, evidence-based clinical information, and bidirectional communication capability.Setting.Academic, tertiary care medical center with an electronic medical record.Intervention.Alerts containing stewardship recommendations and immediate access to the navigator were created.Results.Antibiotic use and response data were collected 1 day before stewardship recommendation via the best practice alert (BPA) tool and 1 day after the BPA tool response. A total of 1,285 stewardship BPAs were created. Two hundred and forty-four (18.9%) of the BPAs were created and acted upon within 72 hours for the purpose of de-escalation: 169 (69%) were accepted, 30 (12%) were accepted with modification, and 45 (18%) were rejected. Statistically significant decreases in total antibiotic use as well as in use of broad-spectrum (anti-methicillin-resistant Staphylococcus aureus and anti-pseudomonal) agents occurred when accepted recommendations were compared with rejected recommendations.Conclusions.We describe the successful development of a clinical decision support tool to perform prospective audit and feedback comprised of an alert and navigator system featuring evidence-based recommendations and clinical and educational information. We demonstrate that this tool improves antibiotic use through our example of de-escalation.Clinical Trials Identifier.This project was registered at ClinicalTrials.gov (NCT01573195).

Outcomes of an electronic medical record (EMR)–driven intensive care unit (ICU)-antimicrobial stewardship (AMS) ward round: Assessing the “Five Moments of Antimicrobial Prescribing”

2019 ◽  
Vol 40 (10) ◽  
pp. 1170-1175 ◽  
Author(s):  
Misha Devchand ◽  
Andrew J. Stewardson ◽  
Karen F. Urbancic ◽  
Sharmila Khumra ◽  
Andrew A. Mahony ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Antimicrobial Stewardship ◽  
Point Prevalence ◽  
Additional Patient ◽  
Face To Face ◽  
Antimicrobial Prescribing ◽  
The Impact

AbstractObjective:The primary objective of this study was to examine the impact of an electronic medical record (EMR)–driven intensive care unit (ICU) antimicrobial stewardship (AMS) service on clinician compliance with face-to-face AMS recommendations. AMS recommendations were defined by an internally developed “5 Moments of Antimicrobial Prescribing” metric: (1) escalation, (2) de-escalation, (3) discontinuation, (4) switch, and (5) optimization. The secondary objectives included measuring the impact of this service on (1) antibiotic appropriateness, and (2) use of high-priority target antimicrobials.Methods:A prospective review was undertaken of the implementation and compliance with a new ICU-AMS service that utilized EMR data coupled with face-to-face recommendations. Additional patient data were collected when an AMS recommendation was made. The impact of the ICU-AMS round on antimicrobial appropriateness was evaluated using point-prevalence survey data.Results:For the 202 patients, 412 recommendations were made in accordance with the “5 Moments” metric. The most common recommendation made by the ICU-AMS team was moment 3 (discontinuation), which comprised 173 of 412 recommendations (42.0%), with an acceptance rate of 83.8% (145 of 173). Data collected for point-prevalence surveys showed an increase in prescribing appropriateness from 21 of 45 (46.7%) preintervention (October 2016) to 30 of 39 (76.9%) during the study period (September 2017).Conclusions:The integration of EMR with an ICU-AMS program allowed us to implement a new AMS service, which was associated with high clinician compliance with recommendations and improved antibiotic appropriateness. Our “5 Moments of Antimicrobial Prescribing” metric provides a framework for measuring AMS recommendation compliance.

Method to the madness: Impact of method of contact on intervention acceptance rates for antimicrobial stewardship interventions

2020 ◽  
Vol 41 (8) ◽  
pp. 959-961
Author(s):  
Ryan W. Stevens ◽  
Hannah D. Fjeld ◽  
Coleman Cutchins ◽  
Benjamin P. Westley
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Antimicrobial Stewardship ◽  
Antimicrobial Stewardship Program ◽  
Stewardship Program ◽  
Acceptance Rates

AbstractWe retrospectively evaluated antimicrobial stewardship program (ASP) interventions over a 63-month period. We compared acceptance rates for those interventions communicated telephonically versus those communicated with a temporary note left in the electronic medical record. Telephonic communication produced superior acceptance rates overall and when analyzed by intervention type and provider.

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