Late Breaking Original Research
Tuesday, November 14, 2023
08:30 AM–10:00 AM
Abstract
Introduction: Antimicrobial stewardship (ASP) programs lead to improved patient outcomes. Pharmacy interventions can be prioritized by leveraging electronic medical record (EMR) automation with clinical decision support tools. Despite a large amount of data on ASP programs in adults, there is currently a lack of data on the optimization of ASP efforts in the pediatric population.
Research Question or Hypothesis: What is the process/impact of a pharmacist-led ASP prioritization scoring tool in the pediatric population?
Study Design: Retrospective, observational, descriptive analysis.
Methods: The Medical University of South Carolina (MUSC) Shawn Jenkins Children’s Hospital (SJCH) is a tertiary care pediatric hospital that is part of MUSC Health, a multicenter, integrated health system. MUSC Health created a multidisciplinary subgroup to develop/implement an ASP scoring, documentation, and intervention tool in the pediatric population. The primary objective of this study was to describe the use/implementation of this prioritization scoring tool for ASP efforts in the pediatric population with a subsequent descriptive evaluation of our program.
Results: The prioritization scoring tool was developed to score patients based on key infection- and antimicrobial-related measures, classifying potential ASP interventions as higher priority based on a higher score. Additionally, an EMR-based smart flow sheet process was generated for documentation of interventions and a monthly report was created to track ASP efforts and improve upon the ASP process. Implementation of the ASP scoring, documentation, and intervention tool began at MUSC Health for pediatric inpatients in January 2022. A six-month analysis revealed documentation for 765 pediatric inpatient encounters. The most frequently documented encounters were for positive blood cultures (39.1%) and pediatric ASP on-call (22.9%). There were 230 recommended ASP interventions with an acceptance rate of 71.3%.
Conclusion: Creation of a scoring/documentation tool can prioritize pediatric patient review, potentially resulting in more timely/effective ASP interventions. This tool could grow ASP in limited resource environments.
Presenting Author
Taylor Morrisette Pharm.D., M.P.H.Medical University of South Carolina College of Pharmacy
Authors
Rachel Burgoon PharmD
Medical University of South Carolina Health
Richard Lueking MD
Medical University of South Carolina Health
Krutika Mediwala Hornback PharmD
Medical University of South Carolina Health
Aaron Hamby PharmD
Medical University of South Carolina Health
Alexandra Mills MD
Medical University of South Carolina Health
Achsah Philip PharmD
Medical University of South Carolina Health
Stephen Thacker MD
Medical University of South Carolina College of Medicine