WIP 142 - Reducing antibiotic overuse in patients hospitalized with uncomplicated community acquired pneumonia: a discharge stewardship quality improvement project
Pediatrics Resident Childrens National - - Washington, DC wASHINGTON, District of Columbia, United States
Background: Despite recent efforts on improving antimicrobial stewardship, antibiotic overuse still represents one of the most serious threats. Currently, most efforts on antimicrobial stewardship programs in pediatric hospitals focus on inpatient prescription. However, stewardship strategies at the time of discharge have been shown to be one of the most effective single strategies. In our center discharge prescriptions are currently not reviewed by our stewardship team. Community acquired pneumonia (CAP) represents the most common infectious diagnosis warranting admission to the hospital, making it an ideal target for a discharge stewardship intervention. Objective: Global aim: To implement an antimicrobial stewardship intervention at the time of patient discharge to reduce length of treatment for patients uncomplicated CAP in a large free standing children’s hospital based on institutional guidelines. Specific aim: to reduce the proportion of long course (more than 7 days) antimicrobial prescriptions at the time of discharge by 20% within 15 months for children hospitalized with uncomplicated CAP in our hospital. Design/Methods: Our key drivers include provider knowledge and practices, pharmacy involvement in discharge prescription and electronic health record practices. Interventions include educating residents and hospitalist division providers as well as pharmacist involvement in discharge prescription and changes in electronic health record order set. The primary outcome measure is the proportion of long course prescriptions at the time of patient discharge. Process measures include frequency of didactic interventions and number of discharge prescriptions changed after review. Balancing measures include ED visit or hospital readmission within 30 days of discharge and adverse medication reactions. Statistical analyses to be performed using statistical processing charts.
