Pharmacist-driven initiative for management of bacteremia using a clinical decision support system.

Purpose: The development and implementation of a clinical decision support system (CDSS) for pharmacists to use for identification of and intervention on patients with Staphylococcus aureus bacteremia (SAB) are described.

Summary: A project team consisting of 3 informatics pharmacists and 2 infectious diseases (ID) pharmacists was formed to develop the CDSS. The primary CDSS component was a scoring system that generates a score in real time for a patient with a positive blood culture for S.

An Automated, Pharmacist-Driven Initiative Improves Quality of Care for Staphylococcus aureus Bacteremia.

Background: Infectious diseases (ID) consultation and antimicrobial stewardship intervention have been shown to improve the management of Staphylococcus aureus bacteremia (SAB). As the workload of antimicrobial stewardship programs (ASPs) continues to increase, ASPs must find a way to maximize the efficiency of the program while optimizing patient outcomes. The objective of this study was to evaluate the impact of incorporating health informatics into the management of SAB via a pharmacist-driven initiative.

Detection of adverse drug events using an electronic trigger tool.

Purpose: Implementation and refinement of an integrated electronic "trigger tool" for detecting adverse drug events (ADEs) is described.

Methods: A three-month prospective study was conducted at a large medical center to test and improve the positive predictive value (PPV) of an electronic health record-based tool for detecting ADEs associated with use of four "trigger drugs": the reversal agents flumazenil, naloxone, phytonadione, and protamine. On administration of a trigger drug to an adult patient, an electronic message was transmitted to two pharmacists, who reviewed cases in near real time (typically, on the same day) to detect actual or potential ADEs.

Effect of barcode-assisted medication administration on emergency department medication errors.

Objectives: Barcode-assisted medication administration (BCMA) is technology with demonstrated benefit in reducing medication administration errors in hospitalized patients; however, it is not routinely used in emergency departments (EDs). EDs may benefit from BCMA, because ED medication administration is complex and error-prone.

Methods: A naïve observational study was conducted at an academic medical center implementing BCMA in the ED.