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Applying a Standard of Care to the Quality Assessment of Bacteremia

Published online by Cambridge University Press:  21 June 2016

Peter A. Gross ,
Zane K. Saul  and
Arpi Kuyumcu
Peter A. Gross*
Affiliation:
Department of Internal Medicine and Pharmacy, Hackensack Medical Center, Hackensack, New Jersey, and New Jersey Medical School, Newark, New Jersey
Zane K. Saul
Affiliation:
Department of Internal Medicine and Pharmacy, Hackensack Medical Center, Hackensack, New Jersey, and New Jersey Medical School, Newark, New Jersey
Arpi Kuyumcu
Affiliation:
Department of Internal Medicine and Pharmacy, Hackensack Medical Center, Hackensack, New Jersey, and New Jersey Medical School, Newark, New Jersey
*
Dept. of Internal Medicine, Hackensack Medical Ctr., Hackensack, NJ 07601
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Abstract

Objective:

To identify an indicator of appropriate antibiotic use for bacteremia that is scientifically sound, that is noncontroversial, and that can be broadly applied as an index of the quality of care.

Design:

Retrospective review of consecutive cases of significant documented bacteremias.

Setting:

Suburban tertiary-care hospital.

Results:

Two hundred ninety-one of 300 (97%) patients received appropriate antibiotics within 48 hours after the final antibiotic sensitivity report was placed on the hospital chart. Therapy was not appropriate in 6 patients with methicillin-resistant Staphylococcus aureus and in 3 patients with enterococcal bacteremia.

Interventions:

Following this study, we instituted a program to prospectively monitor antibiotic use in bacteremias. During the most recent 1-year period, the infectious disease fellow or pharmacist called the attending physician to change antibiotics in 84 of 731 (11.5%) patients with bacteremia. The program was well-accepted by attending physicians.

Conclusions:

A scientifically sound, non-controversial standard of care was identified and used to evaluate the appropriateness of antibiotic use. When this standard was applied prospectively and incorporated into the hospital's routine operations, the quality of care was improved.

Type
Brief Report
Information
Infection Control & Hospital Epidemiology , Volume 13 , Issue 7 , July 1992 , pp. 403 - 406
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1992

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