scholarly journals 1843. Prescribers’ Characteristics and Unnecessary/Inappropriate Antimicrobial Prescription in the Emergency Department: An Observational Study at a Tertiary Care Center

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S526-S526
Author(s):  
Yasuaki Tagashira ◽  
Naofumi Yamane ◽  
Satoshi Miyahara ◽  
Azusa Orihara ◽  
Yuki Uehara ◽  
...  
Keyword(s):  
Emergency Department ◽  
Observational Study ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Antimicrobial Prescription

scholarly journals Misuse of Discharge Antimicrobial Prescription in the Emergency Department: An Observational Study at a Tertiary Care Center

2019 ◽  
Vol 6 (2) ◽  
Author(s):  
Yasuaki Tagashira ◽  
Naofumi Yamane ◽  
Satoshi Miyahara ◽  
Azusa Orihara ◽  
Yuki Uehara ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Observational Study ◽  
Infectious Diseases ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Related Factors ◽  
Antimicrobial Prescription

Abstract We conducted a restrospective cohort study of patients discharged from the emergency department at a tertiary care center with an antimicrobial prescription. More than half of the prescribed antimicrobials were misused and frequently inappropriate for various infectious diseases. In this study, we analyzed the physician-related and environment-related factors predicting misuse.

scholarly journals 2024. A Multifaceted Intervention to Improve Oral Antimicrobial Prescription at the Emergency Department at a Japanese Tertiary Care Center

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S679-S679
Author(s):  
Yasuaki Tagashira ◽  
Hitoshi Honda
Keyword(s):  
Emergency Department ◽  
Care Center ◽  
Tertiary Care ◽  
Developed Countries ◽  
Multifaceted Intervention ◽  
Evidence Based ◽  
Antimicrobial Use ◽  
Tertiary Care Center ◽  
Appropriate Prescription ◽  
Antimicrobial Prescription

Abstract Background The emergency department (ED) is one of the most important settings where antimicrobials are frequently prescribed in developed countries, and at least 30% of antimicrobials prescribed at the ED are inappropriate. Some studies revealed that various factors, especially the physician-related factors were associated with inappropriate antimicrobial use. Implementing effective strategies to modify prescribing practice is needed to optimize antimicrobial therapy at the ED. Methods We implemented a multifaceted intervention to patients discharged with oral antimicrobial agents in the ED at a Japanese tertiary care center from October 2018 to March 2019. The intervention included (1) an educational didactic session to physicians, (2) an evidence-based tool book regarding antimicrobial use for common diagnoses, (3) antimicrobial order sets for common diagnoses, (4) monthly reports of the appropriateness of antimicrobial use, and (5) post-prescription review and feedback by an infectious diseases physician. The proportion of appropriate discharge antimicrobial prescription at ED, and changes in the prescription density, measured as the number of prescription per 1,000 patient visits between pre- and post-intervention were evaluated. Results The total number of patient visits at the ED during the study period was 52,274. With the intervention, the mean monthly discharge antimicrobial prescription decreased from 42.7 to 34.2 per 1,000 visits (proportional reduction 0.20; P < 0.01). Overall, appropriate prescription rate significantly increased from 47.7% (742/1,555) to 77.4% (421/544) (P < 0.01). The rate of unnecessary and inappropriate discharge antimicrobial prescription accounted from 27.5% (428/1,555) and 21.7% (337/1,555) to 8.5% (46/544) and 10.7% (58/544), respectively. A substantial improvement in discharge antimicrobial prescription against intra-abdominal infections and odontogenic infections during the intervention period was observed (changes in the proportion of appropriate prescription was 0.37 [P < 0.01] and 0.51 [P < 0.01], respectively. Conclusion An evidence-based, multifaceted intervention led to decreasing unnecessary prescription and optimizing physicians’ antimicrobial prescriptions at the ED. Disclosures All authors: No reported disclosures.

scholarly journals Medical Trainee Continuity of Care Following Emergency Department Consultations in a Pediatric Hospital

2016 ◽  
Vol 8 (1) ◽  
pp. 33-38 ◽  
Author(s):  
Kim Bjorklund ◽  
Emily A. Eismann ◽  
Roger Cornwall
Keyword(s):  
Emergency Department ◽  
Continuity Of Care ◽  
Broad Spectrum ◽  
Medical Records ◽  
Care Center ◽  
Tertiary Care ◽  
Well Being ◽  
Tertiary Care Center ◽  
Pediatric Hospital ◽  
Medical Trainee

ABSTRACT Background The importance of continuity of care in training is widely recognized; however, a broad-spectrum assessment across all specialties has not been performed. Objective We assessed the continuity of care provided by trainees, following patient consultations in the emergency department (ED) across all specialties at a large pediatric tertiary care center. Methods Medical records were reviewed to identify patients seen in consultation by a resident or fellow trainee in the ED over a 1-year period, and to determine if the patient followed up with the same trainee for the same condition during the next 6 months. Results Resident and fellow trainees from 33 specialties participated in 3400 ED consultations. Approximately 50% (1718 of 3400) of the patients seen in consultation by a trainee in the ED followed up with the same specialty within 6 months, but only 4.1% (70 of 1718) followed up with the same trainee for the same condition. Trainee continuity of care ranged from 0% to 21% among specialties, where specialties with resident clinics (14.4%) have a greater continuity of care than specialties without resident clinics (2.7%, P &lt; .001). Continuity of care did not differ between fellows (4.2%) and residents (4.0%, P = .87), but did differ between postgraduate years for residents (P &lt; .001). Conclusions Trainee continuity of care for ED consultations was low across all specialties and levels of training. If continuity of care is important for patient well-being and trainee education, efforts to improve continuity for trainees must be undertaken.

scholarly journals Metabolic syndrome in alopecia areata: an observational study at a tertiary care center

2021 ◽  
Vol 7 (5) ◽  
pp. 647
Author(s):  
Subrata Kumar Das ◽  
Saptadipa Das
Keyword(s):  
Metabolic Syndrome ◽  
Observational Study ◽  
Alopecia Areata ◽  
Care Center ◽  
Tertiary Care ◽  
Age Group ◽  
Tertiary Care Center ◽  
Cross Sectional ◽  
Laboratory Parameters ◽  
Number Of Patients

<p class="abstract"><strong>Background:</strong> The aim was to evaluate the parameters of metabolic syndrome (MS) in patients of alopecia areata and to investigate the possibility of an existing relationship between MS and alopecia areata (AA).</p><p class="abstract"><strong>Methods:</strong> This cross-sectional observational study included 50 patients with AA who attended OPD of department of dermatology at a tertiary care center during a period of 1 year. Clinical and laboratory parameters were noted in each patient.<strong></strong></p><p class="abstract"><strong>Results:</strong> This study included 50 patients with AA (33 males and 17 females). In the present study maximum number of patients belonged to the age group 20-30 years with 23 patients, followed by 30-40 years with 17  patients. Most of the study subjects, 17 were college students and number of employees were 15. Out of 50 patients 44  had patch(es) and 2 patient had alopecia totalis. In this study out of 50 patients, 38 had mild AA, 7 had AA and 5 patients had severe AA. No significant derangement of clinical and laboratory parameters of MS observed in patients of AA.</p><p class="abstract"><strong>Conclusions:</strong> In the present study we did not observe any significant derangement of clinical and laboratory parameters of  MS  in patients of alopecia areata.</p>

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