Implementation of a pharmacy-driven rapid bacteremia response program
Ashley M Wilde, Matthew Song, W Paul Allen, Alan D Junkins, James M Frazier, Sarah E Moore, Paul S Schulz- Health Policy
- Pharmacology
Abstract
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Purpose
This report describes a comprehensive pharmacy-driven rapid bacteremia response program.
Summary
This novel program positioned the pharmacy department at a large health system to receive and respond to critical microbiologic diagnostic testing results. The program empowered pharmacists to make appropriate adjustments in therapy per protocol. In the first year after program implementation, 2,282 blood culture Gram stains and 2,046 rapid diagnostic test results were called in to the pharmacy department. Gram-positive cocci in clusters was the most commonly identified morphology (n = 946, 44%), followed by gram-negative bacilli (n = 734, 34%). Gram-positive cocci in pairs and/or chains were identified in 249 (12%) of patients, with gram-positive bacilli (n = 125, 5%), yeast (n = 60, 3%) and other organisms (n = 55, 2%) being even less common. The program reduced the mean time to effective therapy in patients who did not already have active antimicrobial orders from over 10 hours to less than 1 hour.
Conclusion
By expanding the scope of pharmacy practice, barriers to optimizing clinical care were overcome.