scholarly journals 60. Penicillin Allergy Delabeling Program in the Post-acute Care Setting

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S148-S148
Author(s):  
Joseph Galipean ◽  
Jerry Jacob
Keyword(s):  
Acute Care ◽  
Care Setting ◽  
Significant Proportion ◽  
Adverse Outcomes ◽  
Penicillin Allergy ◽  
Acute Care Setting ◽  
Beta Lactam ◽  
History Of ◽  
Ige Mediated ◽  
Post Acute Care

Abstract Background A significant proportion of inpatients labeled with penicillin allergies do not have a true IgE-mediated hypersensitivity, which may unnecessarily limit options for treatment of infection and lead to suboptimal antibiotic selection. Post-acute care settings may provide a unique opportunity to capture patients at risk for adverse outcomes related to penicillin allergy labels. The objective of the study was to assess the feasibility and impact of a penicillin delabeling program in an inpatient rehab setting. Methods We conducted a prospective observational study. Inpatients with penicillin allergies were identified weekly by manual review of electronic medical records. A clinical pharmacist reviewed each patient’s chart and identified patients for inclusion. Patients were excluded if they had a history of IgE-mediated hypersensitivity to penicillin within last 5 years, a history of a non-IgE mediated hypersensitivity, were severely immunocompromised, or were prescribed a contraindicated medication. Results A total of 72 charts were reviewed over nine months, and 37 (51.4%) had their penicillin allergy updated to reflect prior beta-lactam tolerance. Of the 72 patient that were evaluated, 28 (38.9%) were eligible for potential penicillin allergy delabeling, and 44 (61.1%) were ineligible. 59 (81.9%) of the patients had a moderate-high risk allergy, 12 (16.6%) had a low risk allergy, and 1 (1.4%) had an intolerance. Of the 28 eligible patients, 11 (39.3%) had their allergy removed, 13 (46.4%) deferred testing, and 4 (14.2%) could not be tested due to staffing. Of the 28 patients that had their allergy delabeled, 7 (21.4%) had their allergy removed by MAR review, 2 (7.2%) had a skin test with a negative result, and 2 (7.2%) had a direct oral challenge with a negative result. Conclusion A penicillin allergy delabeling program using a collaborative physician-pharmacist team model efficiently removed reported allergies in post-acute care patients. The post-acute care setting is an opportune environment to conduct a penicillin allergy delabeling program for patients not currently needing acute medical treatment. Disclosures All Authors: No reported disclosures

Abstract P301: Evaluating the Impact of a Pharmacist-Managed Hypertension Collaborative Care Model in Vascular Neurology Patients in an Inpatient Acute Care Setting

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Ann Smith ◽  
Kathleen Bledsoe ◽  
Thomas Madden ◽  
Jamie Artale ◽  
Ted Sindlinger
Keyword(s):  
Blood Pressure ◽  
Acute Care ◽  
Care Setting ◽  
Management Practice ◽  
Primary Objective ◽  
Adverse Outcomes ◽  
Acute Care Setting ◽  
Percentage Reduction ◽  
Improvement Project ◽  
The Impact

Introduction: The utility of pharmacist-managed collaborative practice agreements (CPA) in the management of hypertension is well established in the outpatient setting. There has been little evaluation of the use of CPAs in the inpatient acute care setting, and none described specifically in the vascular neurology population. Treatment of hypertension is a critical intervention for the secondary prevention of acute ischemic stroke. This quality improvement project evaluated the implementation of a CPA for the inpatient acute care management of hypertension in vascular neurology patients at University of Virginia Health. Methods: A CPA was developed between the neurosciences clinical pharmacist group and the inpatient vascular neurology service, legally vetted, and implemented in June 2019. All vascular neurology patient charts in which an electronic CPA referral was placed from June 2019 through June 2020 were reviewed. Patients were excluded if they were discharged within 24 hours of the referral being placed. The primary objective was to describe and evaluate the implementation of a pharmacist-driven hypertension management practice in the inpatient acute care setting. All patient demographic and clinical data were analyzed using descriptive statistics. Secondary safety outcomes included documented hypotensive events (SBP <90) and acute kidney injury (AKI, increase in SCr by 0.3 mg/dl within 48 hours). Results: During the study period, 26 referrals were placed, and 19 patients were included for review. On average, patients were on 2 anti-hypertensive medications prior to admission. From the time of referral to discharge (mean 6 days), systolic blood pressure (SBP) was reduced on average by 36 mmHg (mean percentage reduction 20%) and diastolic blood pressure (DBP) by 12 mmHg (mean percentage reduction 7%). Ten patients (53%) met the goal of SBP < 140 at discharge. There were 5 hypotensive events and 4 instances of AKI, all of which were mild and recovered prior to discharge. Conclusion: A pharmacist-managed hypertension CPA was successfully implemented in vascular neurology patients in the inpatient acute care setting. The practice demonstrated improved blood pressure control and minimal adverse outcomes.

Creating an Age-Friendly Health System: Lessons learned for the Post-Acute Care Setting

2020 ◽  
Vol 21 (3) ◽  
pp. B17-B18
Author(s):  
Anna Liggett ◽  
Anna Liggett ◽  
June M. McKoy ◽  
Sara Bradley ◽  
Katherine O'Brien ◽  
...  
Keyword(s):  
Health System ◽  
Acute Care ◽  
Care Setting ◽  
Lessons Learned ◽  
Acute Care Setting ◽  
Post Acute Care

Weaning children from mechanical ventilation in a post-acute care setting

2006 ◽  
Vol 9 (4) ◽  
pp. 365-372 ◽  
Author(s):  
Jane E. O’Brien ◽  
David J. Birnkrant ◽  
Helene M. Dumas ◽  
Stephen M. Haley ◽  
Sharon A. Burke ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Acute Care ◽  
Care Setting ◽  
Acute Care Setting ◽  
Post Acute Care

Model for Rehabilitation of Head Injured Adults in the Post Acute Care Setting

1987 ◽  
Vol 18 (2) ◽  
pp. 39-45 ◽  
Author(s):  
Frank D. Lewis ◽  
William H. Burke ◽  
Roger Carrillo
Keyword(s):  
Acute Care ◽  
Functional Assessment ◽  
Behavior Management ◽  
Care Setting ◽  
Emotional Functioning ◽  
Management Program ◽  
Acute Care Setting ◽  
Head Injured ◽  
Specific Barriers ◽  
Post Acute Care

Traumatic brain iniury (TBI) often results in dramatic and adverse changes in physical, cognitive and emotional functioning that preclude the victim's return to his/her premorbid lifestyle. This paper presents a five phase interdisciplinary model for post-acute recovery from TBI. The model includes a comprehensive functional assessment, an intensive behavior management program, and prescriptive retraining programs tailored to reduce specific barriers to greater independence and a better quality lifestyle.

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