Hostname: page-component-848d4c4894-nr4z6 Total loading time: 0 Render date: 2024-05-23T21:39:32.107Z Has data issue: false hasContentIssue false

Implementation of a Clinical Decision Support System for Antimicrobial Stewardship

Published online by Cambridge University Press:  02 January 2015

Elizabeth D. Hermsen*
Affiliation:
Pharmacy Relations and Clinical Decision Support, Nebraska Medical Center, Omaha, Nebraska; and Department of Pharmacy Practice, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska
Trevor C. VanSchooneveld
Affiliation:
Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska
Harlan Sayles
Affiliation:
Biostatistics Department, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
Mark E. Rupp
Affiliation:
Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska
*
65 Hayden Avenue, Lexington, MA 02421 (elizabeth.hermsen@cubist.com)

Abstract

Clinical decision support systems (CDSSs) for antimicrobial stewardship require considerable human resources and financial investments. This pre-/postimplementation study evaluated the effect of a CDSS on performance of prospective audit with intervention and feedback and demonstrated an increase in interventions and recommendation acceptance countered by a substantial number of non-actionable alerts.

Type
Concise Communication
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Kunin, CM, Johansen, KS, Worning, AM, Daschner, FD. Report of a symposium on use and abuse of antibiotics worldwide. Rev Infect Dis 1990;12:1219.Google Scholar
2. Maki, DG, Schuna, AA. A study of antimicrobial misuse in a university hospital. Am J Med Sci 1978;275:271282.Google Scholar
3. Dellit, TH, Owens, RC, McGowan, JE Jr., et al. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis 2007;44:159177.CrossRefGoogle Scholar
4. Evans, RS, Pestotnik, SL, Classen, DC, Burke, JR Evaluation of a computer-assisted antibiotic-dose monitor. Ann Pharmacother 1999;33:10261031.Google Scholar
5. Evans, RS, Pestotnik, SL, Classen, DC, et al. A computer-assisted management program for antibiotics and other antiinfective agents. N Engl J Med 1998;338:232238.Google Scholar
6. McGregor, JC, Weekes, E, Forrest, GN, et al. Impact of a computerized clinical decision support system on reducing inappropriate antimicrobial use: a randomized controlled trial. J Am Med Inform Assoc 2006;13:378384.Google Scholar
7. Mullett, CJ, Evans, RS, Christenson, JC, Dean, JM. Development and impact of a computerized pediatric antiinfective decision support program. Pediatrics 2001;108:E75.Google Scholar
8. Paul, M, Andreassen, S, Tacconelli, E, et al. Improving empirical antibiotic treatment using TREAT, a computerized decision support system: cluster randomized trial. J Annmicrob Chemother 2006;58:12381245.Google Scholar
9. Pestotnik, SL, Classen, DC, Evans, RS, Burke, JP. Implementing antibiotic practice guidelines through computer-assisted decision support: clinical and financial outcomes. Ann Intern Med 1996;124:884890.CrossRefGoogle ScholarPubMed
10. Thursky, KA, Buising, KL, Bak, N, et al. Reduction of broad-spectrum antibiotic use with computerized decision support in an intensive care unit. Int J Qual Health Care 2006;18:224231.Google Scholar
11. Drew, RH, White, R, MacDougall, C, Hermsen, ED, Owens, RC Jr. Insights from the Society of Infectious Diseases Pharmacists on antimicrobial stewardship guidelines from the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Pharmacotherapy 2009;29:593607.CrossRefGoogle Scholar
12. Njoku, JC, Hermsen, ED. Antimicrobial stewardship in the intensive care unit: a focus on potential pitfalls. J Pharm Pract 2010;23:5060.Google Scholar
13. Thursky, KA. Use of computerized decision support systems to improve antibiotic prescribing. Expert Rev Anti Infect Ther 2006; 4:491507.Google Scholar