scholarly journals 706. Impact of Infectious Disease Consultation on Management and Clinical Outcomes of Infective Endocarditis: Results of an interrupted time series analysis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S403-S404
Author(s):  
Takayuki Okura ◽  
Kentaro Iwata ◽  
Goh Ohji
Keyword(s):  
Clinical Outcomes ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Interrupted Time Series ◽  
Care Hospital ◽  
Clinical Failure ◽  
Interrupted Time Series Analysis ◽  
Post Intervention ◽  
Segmented Regression Analysis ◽  
New Onset

Abstract Background Infective endocarditis (IE) is associated with significant morbidity and mortality, and successful management requires expertise in both cardiac surgery and infectious disease (ID). However, the impact of ID consultation on clinical outcomes of IE is not clear. Methods The present study was a quasi-experimental, interrupted time series analysis of the clinical outcomes of patients with IE before (April 1998–April 2008) and after (May 2008–March 2019) the establishment of an ID department at a tertiary care hospital in Japan. The primary outcome was clinical failure within 90 days, defined as a composite of all-cause mortality, unplanned cardiac surgery, new-onset embolic events, and relapse of bacteremia caused by the original pathogen. Results Of 238 IE patients, 59 patients (25%) were treated in the pre-intervention period, and 179 patients (75%) were treated in the post-intervention period. Establishment of an ID department was associated with a 54% reduction in clinical failure (relative risk [RR], 0.46; 95% confidence interval [CI], 0.21–1.02; P=0.054) and a 79% reduction in new-onset embolic events (RR, 0.21; 95% CI, 0.07–0.71; P=0.01). In addition, the rate of inappropriate IE management significantly decreased (RR, 0.06; 95% CI, 0.02–0.22; P< 0.01). Segmented regression analysis for monthly rates of clinical failure. Table 1. Comparison of the clinical characteristics of the patients between the pre-intervention and post-intervention periods Table 2. Segmented regression analysis for primary and secondary outcomes Conclusion Establishment of an ID department at a tertiary care hospital was associated with improved management, better clinical outcomes, and reduced embolic events in patients with IE admitted to the hospital. Disclosures All Authors: No reported disclosures

scholarly journals Impact of restricting procalcitonin measurements in a Swiss tertiary-care hospital on antibiotic use, clinical outcomes, and costs: An interrupted time-series analysis

2020 ◽  
pp. 1-3
Author(s):  
Mohamed Abbas ◽  
Nathalie Vernaz ◽  
Elodie von Dach ◽  
Nicolas Vuilleumier ◽  
Stephan J. Harbarth ◽  
...  
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Interrupted Time Series ◽  
Antibiotic Use ◽  
Care Hospital ◽  
Interrupted Time Series Analysis ◽  
Series Analysis ◽  
The Impact

Abstract We evaluated the impact of a restriction of procalcitonin measurements on antibiotic use, length of stay, mortality, and cost in a Swiss tertiary-care hospital using interrupted time-series analysis. There was no significant change in level or slope for rates of antibiotic consumption, and costs decreased considerably, by ~54,488 CHF (US$55,714) per month.

THE IMPACT OF ANTIMICROBIAL STEWARDSHIP ON THE PATTERNS OF ANTIBIOTICS’ PRESCRIPTION AND CLINICAL OUTCOMES IN THE MEDICAL WARD OF A MALAYSIAN TERTIARY CARE HOSPITAL

2021 ◽  
pp. 20-25
Author(s):  
OVAIS ULLAH SHIRAZI ◽  
NORNY SYAFINAZ AB RAHMAN ◽  
CHE SURAYA ZIN ◽  
HANNAH MD MAHIR ◽  
SYAMHANIN ADNAN
Keyword(s):  
Length Of Stay ◽  
Clinical Outcomes ◽  
Antimicrobial Stewardship ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Medical Ward ◽  
Prescribing Patterns ◽  
Care Hospital ◽  
Slope Change ◽  
The Impact

Objective: To evaluate the impact of antimicrobial stewardship (AMS) on antibiotic prescribing patterns and certain clinical outcomes, the length of stay (LOS) and the re-admission rate (RR) of the patients treated within the medical ward of a tertiary care hospital in Malaysia. Methods: This quasi-experimental study was conducted retrospectively. The prescriptions of the AMS included alert antibiotics (AA) such as cefepime, ceftazidime, colistin (polymyxin E), imipenem-cilastatin, meropenem, piperacillin-tazobactam and vancomycin were reviewed for the period of 24 mo before (May, 2012–April, 2014) and after (May, 2014–April, 2016) the AMS implementation for the patients who were treated within the medical ward of a Malaysian tertiary care hospital. Patterns of antibiotics prescribed were determined descriptively. The impact of the AMS on the length of stay (LOS) and readmission rate (RR) was determined by the interrupted time series (ITS) comparative analysis of the pre-and post-AMS segments segregated by the point of onset (May, 2014) of the AMS program. Data analysis was performed through autoregressive integrated moving average (ARIMA) Winter Additive model and the Games-Howell non-parametric post hoc test by using IBM Statistical Package for Social Sciences version 25.0 for Windows (SPSS Inc., Chicago, IL, USA). Results: A total of 1716 prescriptions of the AA included for the AMS program showed that cefepime (623, 36.3%) and piperacillin-tazobactam (424, 24.7%) were the most prescribed antibiotics from May 2012 to April 2016. A 23.6% drop in the number of the AA prescriptions was observed during the 24-month post-AMS period. The LOS of the patients using any of the AA showed a post-AMS decline by 3.5 d. The patients’ LOS showed an average reduction of 0.12 (95% CI, 0.05–0.19, P=0.001) with the level and slope change of 0.18 (95% CI, 0.04–0.32, P=0.02) and 0.074 (95% CI, 0.02–0.12, P=0.002), respectively. Similarly, the percent RR reduced from 20.0 to 9.85 during the 24-month post-AMS period. The observed post-AMS mean monthly reduction of the RR for the patients using any AA was 0.38 (95% CI, 0.23–0.53, P<0.001) with the level and slope change of 0.33 (95% CI, 0.14–0.51, P=0.02) and 0.37 (95% CI, 0.16–0.58, P=0.001), respectively. Conclusion: The AMS program of a Malaysian tertiary care hospital was a coordinated set of interventions implemented by the AMS team of the hospital that comprised of the infectious diseases (ID) physician, clinical pharmacists and microbiologist. The successful implementation of the AMS program from May, 2014 to April, 2016 within the medical ward resulted in the drop of the number of AA prescriptions that sequentially resulted in the significant (P<0.05) post-AMS reduction of the LOS and the RR.

scholarly journals IMPACT OF CERTAIN EDUCATIONAL INTERVENTIONS ON ADVERSE DRUG REACTION REPORTING BY NURSING HEALTH PROFESSIONALS AT A TERTIARY CARE HOSPITAL

2020 ◽  
pp. 175-180
Author(s):  
SUPRIYA SONOWAL ◽  
CHETNA K DESAI ◽  
JIGAR R PANCHAL
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Health Professionals ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Educational Interventions ◽  
Care Hospital ◽  
Post Intervention ◽  
Adr Reporting ◽  
Nursing Health

Objectives: The objectives of the study were to evaluate the impact of certain educational interventions on adverse drug reaction (ADR) reporting by nursing health professionals at a tertiary care hospital. Methods: Knowledge, attitude, and practice (KAP) of the nurses regarding ADR reporting were evaluated before and after interventions using a KAP questionnaire. Educational interventions carried out among the nurses were workshops, booklets, SMSes, personal briefings, and posters. Number and quality of ADR reported by nurses in pre-intervention (3 months), intervention (10 months), and post-intervention (3 months) phase were compared. Results: There was a significant increase in response rate to questionnaires in the post-intervention phase (post-IP) (97.74%) as compared to pre-intervention (91.28%) phase (pre-IP). The knowledge score of the nurses increased significantly in post-IP (11.65 ± 2.14) as compared to the pre-intervention (6.98 ± 2.46) phase. No ADR was reported by nurses in pre-IP. Thirty nurses reported 30 ADRs in the intervention phase and six nurses reported six ADRs in the post-IP. The mean score of completeness of ADR notification forms decreased significantly in post-IP. Maximum ADRs (10) were reported after the workshops. Conclusion: Educational interventions improved the KAP of ADR reporting by nurses, albeit temporary. This suggests the need of continuous educational interventions.

scholarly journals Evaluating the Clinical Outcomes of Remdesivir Among Patients Admitted With COVID-19 in a Tertiary Care Hospital

Cureus ◽  
2021 ◽  
Author(s):  
Ahmad G Butt ◽  
Jahanzeb Ahmed ◽  
Syed Muhammad Huzaifa Shah ◽  
Camilo Andrés Avendaño Capriles ◽  
Hady Al-Rihani ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital
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