Background: The purpose of this study was to evaluate the impact of infectious diseases consultation (IDC) and a real-time antimicrobial stewardship (AMS) review on the management of bacteremia (SAB).
Methods: This retrospective study included adult inpatients with SAB from January 2016 to December 2018 at 7 hospitals. Outcomes were compared between 3 time periods: before mandatory IDC and AMS review (period 1), after mandatory IDC and before AMS review (period 2), and after mandatory IDC and AMS review (period 3). The primary outcome was bundle adherence, defined as appropriate intravenous antimicrobial therapy, appropriate duration of therapy, appropriate surveillance cultures, echocardiography, and removal of indwelling intravenous catheters, if applicable. Secondary end points included individual bundle components, source control, length of stay (LOS), 30-day bacteremia-related readmission, and in-hospital all-cause mortality.
Results: A total of 579 patients met inclusion criteria for analysis. Complete bundle adherence was 65% in period 1 (n = 241/371), 54% in period 2 (n = 47/87), and 76% in period 3 (n = 92/121). Relative to period 3, bundle adherence was significantly lower in period 1 (odds ratio [OR], 0.58; 95% confidence interval [CI], 0.37-0.93; = .02) and period 2 (OR, 0.37; 95% CI, 0.20-0.67; = .0009). No difference in bundle adherence was noted between periods 1 and 2. Significant differences were seen in obtaining echocardiography (91% vs 83% vs 100%; < .001), source control (34% vs 45% vs 45%; = .04), and hospital LOS (10.5 vs 8.9 vs 12.0 days; = .01). No differences were noted for readmission or mortality.
Conclusions: The addition of AMS pharmacist review to mandatory IDC was associated with significantly improved quality care bundle adherence.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288607 | PMC |
| http://dx.doi.org/10.1093/ofid/ofaa184 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Perioperative emergency laparotomy pathway for patients undergoing emergency laparotomy: A propensity score matched study.
Ann Acad Med Singap
December 2024
Department of Surgery, Ng Teng Fong General Hospital, Singapore.
Introduction: Emergency laparotomy (EL) is associated with high morbidity and mortality, often exceeding 10%. This study evaluated the impact of the EMergency Laparotomy Audit (EMLA) interdisciplinary perioperative pathway on patient outcomes, hospital costs and length of stay (LOS) within a single centre.
Method: A prospective cohort study was conducted from August 2020 to July 2023.
Pharmacist-led antimicrobial stewardship program in the treatment of bacteraemia in paediatric patients: a multivariate analysis.
Infect Prev Pract
December 2024
Antimicrobial Stewardship Program, Pequeno Príncipe Hospital, Curitiba, PR, Brazil.
Background: Care bundles are a recognised strategy to improve treatment. When managed through an Antimicrobial Stewardship Program (ASP) based on the pharmacist-led program model, care bundles can be an effective tool to guide decision making in clinical practice and to improve patient outcomes. This study aimed to evaluate the results of a pharmacist-led ASP which included a care bundle based on clinical outcomes of bacteraemia (SAB) in a paediatric hospital.
View Article and Find Full Text PDFDevelopment and Usability Evaluation of a Mhealth Application for Health-Care Associated Infections among Health-Care Providers in Malaysia.
J Pharm Bioallied Sci
October 2024
Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia (IIUM), Kuantan, Malaysia.
Background: The effectiveness of reducing healthcare-associated infections (HCAIs) depends on increasing healthcare providers' awareness, skills, and adherence to standard practices. Mhealth applications provide an innovative approach to enhancing access to information and resources while reducing time and expenses.
Objective: The study aimed to develop and evaluate a mhealth application for healthcare providers that offers quick access to updated recommendations, evidence-based guidelines, and protocols for managing patients with HCAIs.
Out-of-Pocket Expenses and Postoperative Therapy After Open Reduction Internal Fixation of a Distal Radius Fracture.
Plast Reconstr Surg
December 2024
Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX.
Background: Postoperative hand therapy after surgery for distal radius fractures is associated with improved functional outcomes. However, financial impediments can be a potential barrier to adherence to postoperative care requirements. The aim of this study is to evaluate the relationship among the surgical and therapy out-of-pocket (OOP) expenses and therapy visits after operative treatment of a distal radius fracture.
View Article and Find Full Text PDFReducing severe intraventricular haemorrhage rates in <26-week preterm infants with bedside assessment and care bundle implementation.
Acta Paediatr
December 2024
Monash Newborn, Monash Children's Hospital, Monash Health, Melbourne, Victoria, Australia.
Aim: To assess staff adherence to a 'Preterm Brain Injury Prevention Bundle', and its effectiveness in reducing severe intraventricular haemorrhage (IVH) rates and risk factors in extremely preterm infants born at <26 weeks' gestation.
Methods: Adherence to the bundle was assessed using a novel bedside assessment tool, with immediate feedback to bedside staff post-assessment. Data on IVH rates and associated risk factors were stratified by IVH severity, and compared between pre- and post-bundle implementation.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!