Category: Federal Forum Posters
Purpose: The purpose was to conduct a retrospective analysis of the procalcitonin utilization pathway that was implemented in July 2017. The goal of the pathway is to implement evidence-based decision making when using PCT as a marker to initiate or discontinue antibiotics. The clinical pathway is currently limited to lower respiratory tract infections and sepsis of unknown origins, areas with the most literature to support its use. This review used data from the clinical pathway to evaluate the adherence of providers to the clinical pathway for the appropriate indications and using it effectively to initiate or discontinue antibiotic therapy.
Methods: This project has gained Institutional Review Board approval. TheraDoc®, a clinical surveillance tool, that captures patient information, lab values and interventions with comments, was utilized to gather data on PCT orders in the date range, and patient chart reviews were conducted as needed. All instances of PCT orders that were tracked in TheraDoc®, orders from 07/01/2017 to 8/31/2018 were included for review to determine if they were ordered appropriately for LRTI or sepsis of unknown origin, and if the clinical pathway was followed. Initially, PCT orders were categorized as meeting a pathway exclusion or ordered for LTRI or sepsis of unknown origin. The PCT orders that met an exclusion criteria were categorized by the criteria so further education opportunities could be identified. The PCT orders for LTRI and sepsis of unknown origin were further categorized; low PCT and clinical pathway adherent to discontinue antibiotics, or high PCT and antibiotics were started or continued. Each PCT order and utilization was also categorized by service (CCU, IM etc.) to determine areas where more targeted education about PCT validation and usage may be useful.
Results: not applicable
Conclusion: not applicable
Florin Iacob– ANMC Pharmacy Resident, Alaska Native Tribal Health Consortium, Eagle River, AK