Change In Culture: Addition of a Clinical Pharmacist to the Emergency Department Antimicrobial Culture Review Process

9.00
Hdl Handle:
http://hdl.handle.net/10755/621165
Category:
Full-text
Format:
Text-based Document
Type:
DNP Capstone Project
Level of Evidence:
Clinical Practice Guideline(s)
Research Approach:
Qualitative Research
Title:
Change In Culture: Addition of a Clinical Pharmacist to the Emergency Department Antimicrobial Culture Review Process
Author(s):
Streiff,Samantha; Ramponi, Denise; Cline,Thomas W.
Additional Author Information:
Samantha Streiff, DNP(c), RN, Denise Ramponi, DNP, FNP-C, ENP-BC, FAANP, FAEN, and Thomas W. Cline, MBA, Ph.D.
Advisors:
Ramponi, Denise
Degree:
DNP
Degree Year:
2016
Grantor:
Robert Morris University
Abstract:

Objective: To evaluate the effectiveness of a unit based pharmacist in assisting with antimicrobial selection of female patients discharged from the emergency department with a diagnosis of an uncomplicated urinary tract infection.

Setting: Academic-affiliated emergency department in Pittsburgh, Pennsylvania.

Methods: A retrospective chart review was conducted among 870 female patients who were discharged from the emergency department with a positive urine culture requiring antimicrobial therapy revision.  The primary investigator abstracted specific medical record information to determine if a pharmacist-driven culture review resulted in a higher percentage of appropriate antimicrobial selection when compared to the standard nurse/physician driven-culture review. The revised antimicrobial therapy treatment plan was deemed appropriate or not based on the “International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: A 2010 Update by the Infectious Disease Society of American and the European Society for Microbiology and Infectious Disease”.

Results: A Chi-Square Test of Independence was conducted to evaluate the relationship between two categorical variables:  (1) type of provider (physician/pharmacists) and (2) adherence to clinical practice guidelines (yes/no).  The test emerged significant, C2 = 17.4, df= 2, p < 0.01.  Thus, a significant relationship between type of provider and appropriate treatment was found.  Specifically, 52.2% of physicians used the appropriate treatment whereas 84.4% of pharmacists used the appropriate treatment.

Keywords:
Emergency Department; Antimicrobial
MeSH:
Emergency Services, Hospital
CINAHL Headings:
Emergency Service; Pharmacists; Antiinfective Agents--Therapeutic Use; Antiinfective Agents
Note:
This work has been approved through a faculty review process prior to its posting in the Virginia Henderson Global Nursing e-Repository.
Repository Posting Date:
2016-12-13T21:48:58Z
Date of Publication:
2016-12-13

Full metadata record

DC FieldValue Language
dc.contributor.advisorRamponi, Deniseen
dc.contributor.authorStreiff,Samanthaen
dc.contributor.authorRamponi, Deniseen
dc.contributor.authorCline,Thomas W.en
dc.date.accessioned2016-12-13T21:48:58Z-
dc.date.available2016-12-13T21:48:58Z-
dc.date.issued2016-12-13-
dc.identifier.urihttp://hdl.handle.net/10755/621165-
dc.description.abstract<p><em>Objective:</em> To evaluate the effectiveness of a unit based pharmacist in assisting with antimicrobial selection of female patients discharged from the emergency department with a diagnosis of an uncomplicated urinary tract infection.</p> <p><em>Setting:</em> Academic-affiliated emergency department in Pittsburgh, Pennsylvania.</p> <p><em>Methods:</em> A retrospective chart review was conducted among 870 female patients who were discharged from the emergency department with a positive urine culture requiring antimicrobial therapy revision.  The primary investigator abstracted specific medical record information to determine if a pharmacist-driven culture review resulted in a higher percentage of appropriate antimicrobial selection when compared to the standard nurse/physician driven-culture review. The revised antimicrobial therapy treatment plan was deemed appropriate or not based on the “International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: A 2010 Update by the Infectious Disease Society of American and the European Society for Microbiology and Infectious Disease”.</p> <p><em>Results:</em> A Chi-Square Test of Independence was conducted to evaluate the relationship between two categorical variables:  (1) type of provider (physician/pharmacists) and (2) adherence to clinical practice guidelines (yes/no).  The test emerged significant, <em>C<sup>2</sup></em><sup> </sup>= 17.4, <em>df</em>= 2, <em>p</em> < 0.01.  Thus, a significant relationship between type of provider and appropriate treatment was found.  Specifically, 52.2% of physicians used the appropriate treatment whereas 84.4% of pharmacists used the appropriate treatment.</p>en
dc.formatText-based Documenten
dc.language.isoen_USen
dc.subjectEmergency Departmenten
dc.subjectAntimicrobialen
dc.subject.meshEmergency Services, Hospitalen
dc.titleChange In Culture: Addition of a Clinical Pharmacist to the Emergency Department Antimicrobial Culture Review Processen_US
dc.typeDNP Capstone Projecten
thesis.degree.grantorRobert Morris Universityen
thesis.degree.levelDNPen
dc.description.noteThis work has been approved through a faculty review process prior to its posting in the Virginia Henderson Global Nursing e-Repository.en_US
dc.primary-author.detailsSamantha Streiff, DNP(c), RN, Denise Ramponi, DNP, FNP-C, ENP-BC, FAANP, FAEN, and Thomas W. Cline, MBA, Ph.D.en
thesis.degree.year2016en
dc.type.categoryFull-texten
dc.evidence.levelClinical Practice Guideline(s)en
dc.research.approachQualitative Researchen
dc.subject.cinahlEmergency Serviceen
dc.subject.cinahlPharmacistsen
dc.subject.cinahlAntiinfective Agents--Therapeutic Useen
dc.subject.cinahlAntiinfective Agentsen
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