Category: Federal Forum Posters
Purpose: The purpose of this retrospective chart review is to investigate current antibiotic prescribing practices for inpatient Veterans at Togus Veterans Affairs Medical Center (VAMC) with a primary or secondary diagnosis of pneumonia. We aim to create a disease-specific computerized order set based on guideline-directed therapy to evaluate for impact on antibiotic prescribing for inpatient Veterans. Null hypothesis: implementation of a guideline-directed, computerized, pneumonia order set will have no impact on total duration of antibiotic therapy for inpatient Veterans.
Methods: A computerized order set for community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP), or ventilator-associated pneumonia (VAP) will be created by a multidisciplinary team consisting of a hospitalist, infectious disease specialist, pharmacist, and quality management representatives using guidelines from the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATC). The order set will be implemented on November 1, 2018 and a patient chart review will be performed before and after implementation, from September 2017 through September 2018 and December 2018 through December 2019, respectively. Patient characteristics will be recorded: ICD-10-CM diagnosis code; admission date and location; discharge date, chronic obstructive pulmonary disease (COPD); Methicillin-resistant Staphylococcus aureus (MRSA) nasal swab; vaccination for 13-valent pneumococcal conjugate (PCV13), 23-valent pneumococcal polysaccharide (PPSV23), and influenza; cultures drawn prior to antibiotics; smoking history; hospitalization within past 30 days. The primary outcome will be the total antibiotic days of therapy prescribed before and after implementation of the order set. Total antibiotic days of therapy will be defined as the total sum of days any antibiotic was given to a patient from admission through discharge according to barcode medication administration (BCMA) log and discharge summary. The primary outcome will be analyzed by the student t-test.
Results: not applicable
Conclusion: not applicable
Brianna Kimball– PGY1 Pharmacy Resident, VA Maine Healthcare System, Wiscasset, ME