Category: Federal Forum Posters
Purpose: Sepsis is a leading cause of death for hospitalized patients; sepsis contributes up to 50% of deaths of hospitalized patients and affects 1 million patients a year in the United States. In order to minimize poor outcomes, the Surviving Sepsis Guideline strongly advocates timely
administration of antibiotics within 1 hour. Prior studies have shown every hour delay in antibiotic administration in a severely ill patient increases mortality by 12%. Thus, the objective of this study is to determine if time to first dose of parental antibiotic administration can be improved by increasing accessibility of antibiotics to the nursing staff.
Methods: During the pre-intervention period (April 2018 – May 2018) all antibiotics were prepared and send to the nurse from the central pharmacy. In the post intervention period (October-November 2018), anchor antibiotics for sepsis including ceftriaxone and cefepime are made available in all floor pyxis stations as ready- to-administer Add-Ease form. The nursing staff received education on the availability of key antibiotics in pyxis, the importance of time-to-first dose antibiotics and the reconstitution techniques of using Add-Ease system. A Pre- and post- quasi-experimental analysis will be conducted to compare difference in antibiotic administration time before and after the intervention. Electronic health record system will be utilized to collect time of the antibiotic order placement by the physician, order verification, and administration time. The number of orders with lapse time < 30 minutes between order and verification will be collected in attempts to identify areas of potential delay. The time from order to first dose of antibiotic administered will be considered as a continuous variable and also divided into three categories for analysis: >60 minutes, >90 minutes and >120 minutes. Chi-squared test or Mann Whitney or student’s t-test will be used to compare the time between the two periods as appropriate.
Results: Not applicable
Conclusion: Not applicable
Joanne Chiu– Pharmacy Resident, LAC+ USC Medical Center, Cypress, CA