Title |
An electronic trigger tool to optimise intravenous to oral antibiotic switch: a controlled, interrupted time series study
|
---|---|
Published in |
Antimicrobial Resistance & Infection Control, August 2017
|
DOI | 10.1186/s13756-017-0239-3 |
Pubmed ID | |
Authors |
Marvin A. H. Berrevoets, Johannes (Hans) L. W. Pot, Anne E. Houterman, Anton (Ton) S. M. Dofferhoff, Marrigje H. Nabuurs-Franssen, Hanneke W. H. A. Fleuren, Bart-Jan Kullberg, Jeroen A. Schouten, Tom Sprong |
Abstract |
Timely switch from intravenous (iv) antibiotics to oral therapy is a key component of antimicrobial stewardship programs in order to improve patient safety, promote early discharge and reduce costs. We have introduced a time-efficient and easily implementable intervention that relies on a computerized trigger tool, which identifies patients who are candidates for an iv to oral antibiotic switch. The intervention was introduced on all internal medicine wards in a teaching hospital. Patients were automatically identified by an electronic trigger tool when parenteral antibiotics were used for >48 h and clinical or pharmacological data did not preclude switch therapy. A weekly educational session was introduced to alert the physicians on the intervention wards. The intervention wards were compared with control wards, which included all other hospital wards. An interrupted time-series analysis was performed to compare the pre-intervention period with the post-intervention period using '% of i.v. prescriptions >72 h' and 'median duration of iv therapy per prescription' as outcomes. We performed a detailed prospective evaluation on a subset of 244 prescriptions to evaluate the efficacy and appropriateness of the intervention. The number of intravenous prescriptions longer than 72 h was reduced by 19% in the intervention group (n = 1519) (p < 0.01) and the median duration of iv antibiotics was reduced with 0.8 days (p = <0.05). Compared to the control group (n = 4366) the intervention was responsible for an additional decrease of 13% (p < 0.05) in prolonged prescriptions. The detailed prospective evaluation of a subgroup of patients showed that adherence to the electronic reminder was 72%. An electronic trigger tool combined with a weekly educational session was effective in reducing the duration of intravenous antimicrobial therapy. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 2 | 33% |
South Africa | 1 | 17% |
Ireland | 1 | 17% |
Unknown | 2 | 33% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Scientists | 2 | 33% |
Practitioners (doctors, other healthcare professionals) | 2 | 33% |
Members of the public | 1 | 17% |
Science communicators (journalists, bloggers, editors) | 1 | 17% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 74 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 12 | 16% |
Student > Bachelor | 8 | 11% |
Other | 7 | 9% |
Researcher | 7 | 9% |
Student > Postgraduate | 5 | 7% |
Other | 12 | 16% |
Unknown | 23 | 31% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 20 | 27% |
Pharmacology, Toxicology and Pharmaceutical Science | 13 | 18% |
Biochemistry, Genetics and Molecular Biology | 4 | 5% |
Nursing and Health Professions | 2 | 3% |
Agricultural and Biological Sciences | 2 | 3% |
Other | 8 | 11% |
Unknown | 25 | 34% |