A Multidisciplinary Pathway for Community-Acquired Pneumonia with Rapid Conversion to Oral Therapy Improves Healthcare Value

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Identifier R_1kUNjBrshu7wa4a_CAP_abstract_EBPF2019
Title A Multidisciplinary Pathway for Community-Acquired Pneumonia with Rapid Conversion to Oral Therapy Improves Healthcare Value
Creator Claire Ciarkowski, MD; Tristan T. Timbrook, PharmD, MBA; Karli Edholm, MD; Nathan D. Hatton, MD; Christy L. Hopkins, MD; Frank Thomas, MD, MB; Matthew N. Sanford, MBA; Elena Igumnova; Russell J. Benefield, PharmD; Polina Kukhareva, MPH, PhD; Ken Kawamoto, MD, MHS, PhD; Emily Spivak MD, MHS
Description A multidisciplinary team with a goal to improve treatment for hospitalized patients with CAP was assembled that included physicians (emergency medicine, medical intensive care unit, infectious disease/antimicrobial stewardship, hospitalists), pharmacy, value engineering, information technology and the quality department. A standardized CAP orderset for patients presenting to the ED was developed. When an ED patient receives a chest radiograph and an antibiotic order, a best practice alert (BPA) is triggered stating, "If this antibiotic is for pneumonia, click ‘Open orderset'." If selected, this orderset provides guidance to providers to appropriately triage patients (ICU admission, Floor admission or Home Discharge), assess the risk for drug resistance, order appropriate diagnostic testing, and select ‘best practice' antibiotics. Patients admitted to the hospital floor are given a single intravenous (IV) antibiotic dose, then are switched to oral antibiotics after 24 hours for a total duration of 5 days. Atypical coverage with azithromycin is discontinued after 24 hours unless Legionella urine antigen returns positive. Pre-implementation training was provided to providers, nurses, respiratory therapists and pharmacists involved in patient care. A stewardship team including an infectious disease physician and pharmacist would review charts of patients on hospitalists teams and provide feedback for consistent antibiotic administration.
Subject Evidence-Based Practice; Community-Acquired Infections; Pneumonia, Viral; Anti-Infective Agents; Administration, Oral; Outcome Assessment (Health Care); Quality Improvement
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 2019
Date Digital 2019
Language eng
ARK ark:/87278/s6xt099x
Relation is Part of 2019 Evidence Based Practice Posters
Format application/pdf
Rights Copyright © College of Nursing, University of Utah
Setname ehsl_ebp
Date Created 2019-04-29
Date Modified 2020-05-06
ID 1423254
Reference URL https://collections.lib.utah.edu/ark:/87278/s6xt099x