scholarly journals 1095. Prevalence and Characteristics of Self-Reported Antibiotic Allergies Across a Multi-Hospital Healthcare System

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S389-S389
Author(s):  
Katherine K Perez ◽  
Ty C Drake ◽  
Amaris Fuentes ◽  
Clare N Gentry
Keyword(s):  
Prevalence Rate ◽  
Medication Safety ◽  
Best Practice ◽  
Hospital Setting ◽  
Hospitalized Patients ◽  
Point Prevalence ◽  
Prevalence Rates ◽  
Community Based ◽  
Hospital System ◽  
Reporting Practices

Abstract Background Collaborations between medication safety and antimicrobial stewardship programs (ASP) have not been well described despite many overlapping best practice initiatives. In partnership with medication safety, the ASP at Houston Methodist (HM) reviews patient safety events submitted by hospital staff and identified a best practice opportunity in allergy reporting practices. Our objective was to benchmark self-reported antibiotic allergies among hospitalized patients and compare the prevalence and characteristics among hospital settings. Methods We evaluated the prevalence of self-reported antibiotic allergies in the electronic medical record for adult patients admitted to any HM entity including 1 flagship referral center (933-beds) and 6 community-based hospitals (1,379-beds) in January 2019. Antibiotics were grouped by class into penicillins, sulfas, cephalosporins, tetracyclines, macrolides, quinolones, and others. Point-prevalence rates were calculated using the total patient count as the denominator. Results There were 4,730 patients admitted to HM in January 2019 of which 85% (n = 4,029) self-reported 9,186 active drug allergies. There were 2,353 (49.7%) individuals who self-reported 3,665 antibiotic allergies, of which 987 (21%) reported an allergy to ≥2 antibiotic classes. The prevalence rate for a penicillin allergy was highest at 26.1% (n = 1,235), followed by allergy to sulfa 15.9% (n = 751) and quinolones 7.9% (n = 411). Antibiotic allergies were most prevalent in patients aged 70–79 (11%, n = 518) and 60–69 (10%, n = 495). Antibiotic allergies were higher among females (61.6%; n = 1,679/2,724) compared with males (40.7%; n = 662/1,305) (P = 0.002). There was no difference in prevalence rates between community-based hospitals and the flagship institution (P = 0.51). Conclusion We identified an antibiotic allergy point prevalence rate of 49.7% among hospitalized patients, including a 26.1% rate to penicillin, across our 7-hospital system. This analysis provides a road map to deploy system-wide efforts to improve antibiotic detailing in patients regardless of the hospital setting. Disclosures All authors: No reported disclosures.

Establishing a multidisciplinary taskforce to improve anticoagulation safety at a large health system

2021 ◽  
Author(s):  
Engie Attia ◽  
Amaris Fuentes ◽  
Mark Vassallo ◽  
Stuart Dobbs ◽  
Peter Nguyen ◽  
...  
Keyword(s):  
Medication Safety ◽  
Best Practice ◽  
Assessment Tool ◽  
Academic Medical Center ◽  
Care Facility ◽  
Self Assessment ◽  
Term Care ◽  
Hospital System ◽  
Key Stakeholders ◽  
Safety Committee

Abstract Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose To describe the development of a multidisciplinary anticoagulant safety taskforce (ASTF) to address anticoagulation-related issues across the medication-use system. Summary Oral and parenteral anticoagulants have been classified as high-alert medications because of their potential for harm. Errors at the point of prescribing, monitoring, and administering therapy have been noted in safety literature. Our hospital system, which includes 1 academic medical center, 6 community hospitals, and 1 long-term care facility, designed a multidisciplinary ASTF to address anticoagulation-related issues. The ASTF used the 2017 Institute for Safe Medication Practices (ISMP) Medication Safety Self-Assessment for Antithrombotic Therapy as the primary tool for reviewing current practices, performing gap analyses, and identifying our greatest areas of opportunity. The top 8 best practice elements related to anticoagulant use were identified for initial efforts of ASTF activity. Meetings were led by a medication safety pharmacist who reviewed process opportunities and actions to address gaps. The hospital chief quality and patient safety officer and the vice president of quality were the executive sponsors of the ASTF. Key stakeholders such as the medication safety committee chair and the president of the medical staff were instrumental in leading the initiative. Recommendations from the ASTF were reviewed and approved by the system medication safety committee and the system pharmacy and therapeutics committee to support system-wide implementation. The ASTF accomplished more than initially planned within its first year. Error mitigation occurred through policy revisions, order set development and modification, and implementation of practice changes to comply with each best practice. The ISMP antithrombotic self-assessment score improved from 67% to 87%, surpassing the initially targeted score of 75%. To overcome implementation barriers with the electronic health record, we enlisted support from our informatics leadership to leverage information technology. Overall, the success of the taskforce was attributed to the teamwork and leadership of key individuals within the organization. Conclusion Leveraging interest from key stakeholders across multiple disciplines with an established assessment tool was key to developing a productive and successful ASTF. The group came together to evaluate anticoagulant-related issues and implement sustainable changes to decrease anticoagulation error potential.

Current Status of Schistosomiasis amongst School Children in Igedeland, Benue State, Nigeria.

2015 ◽  
Vol 6 ◽  
pp. 16-21
Author(s):  
P O Uweh ◽  
E A Omudu ◽  
I E Onah
Keyword(s):  
School Children ◽  
Prevalence Rate ◽  
Current Status ◽  
Age Group ◽  
Prevalence Rates ◽  
Community Based ◽  
School Aged Children ◽  
Sedimentation Technique ◽  
Stool Samples ◽  
Group 5

The current status of S. haematobium and S. mansoni infections among school-aged children in Oju and Obi LGAs of Benue State was investigated between July to October 2012. 786 urine and stool samples were examined using the sedimentation technique. In Oju the prevalence of S. haematobium and S. mansoni was 77 (19.3%) and 23 (5.8%) respectively. Males had a 2 prevalence of 54(20.8%) which was significantly higher than females 23(16.4%). (÷ =7.81, df = 3, P < 0.05). The prevalence rate for S. mansoni infection of males in Oju was 18 (7.0%) and females 5 (3.69%). Age group 11-15years had the highest infection rate of (18.8%) for S. haematobium and 15.2% for S. mansoni. The prevalence rates varied with age reaching the peak among age group 5-10 years (21.4%) for S. haematobium and 7.6% for S. mansoni infection. The overall indices of infection were generally highest in the 11-15years age group. Children between 5-10years contributed 93.7% of the daily egg output. Our findings justify the urgent need to develop an integrated community-based intervention that addresses the water andsanitation needs of the communities.

Prevalence of musculoskeletal symptoms among Hong Kong nurses

2005 ◽  
Vol 4 (3) ◽  
pp. 199-208
Author(s):  
Simon S. Yeung ◽  
Ash Genaidy ◽  
Linda Levin
Keyword(s):  
Hong Kong ◽  
Lower Extremity ◽  
Prevalence Rate ◽  
Hospital Setting ◽  
Study Participant ◽  
Musculoskeletal Symptoms ◽  
Body Region ◽  
Prevalence Rates ◽  
Body Regions ◽  
Lower Back

This study aims to investigate how different prevalence selection criteria affect the prevalence rates of musculoskeletal symptoms in single and multiple body regions among female nurses working in a hospital setting in the Hong Kong area. Results showed that the 12-month prevalence rate for each body region was consistently higher than the 1-month prevalence rate. The 1-month prevalence rate for lower back was 59%, and 30–39% for lower extremity, upper back and neck, and the corresponding values for 12-month prevalence rates were 98% for lower back, and 89–91% for lower extremity, upper back, and neck. A similar trend was recorded for the 12-month prevalence of musculoskeletal disorder cases (MSD) (a case was defined as a reported symptom by the study participant, which is characterized by high frequency and/or intensity symptom) in the lower back (42%), knees/lower legs (30%), upper back (23%), hips – thigh (21%), and shoulders (21%). The 12-month MSD prevalence rates for lower back and one other body region ranged from 6% to 17%. The prevalence of MSD in the lower back – knees – and hips or ankles ranged from 11% to 12%. In addition, MSD cases in the lower back regions were significantly associated with those in the upper back, hip, knee, and hand regions. It is concluded that musculoskeletal symptoms are prevalent in single and multiple body regions, and symptoms originating from one body region may be associated with those in other body regions. A holistic approach in the evaluation and prevention of musculoskeletal problems for high-risk occupations is needed.

Cardiovascular and Respiratory Comorbidities in Patients with Bipolar Disorder: A Systematic Review

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
J.M. Montes ◽  
J. Mostaza ◽  
F. Rico-Villademoros ◽  
J. Saiz-Ruiz ◽  
J. Bobes ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
General Population ◽  
Prevalence Rate ◽  
Point Prevalence ◽  
Lifetime Prevalence ◽  
Clinical Samples ◽  
Prevalence Rates ◽  
Medline Search ◽  
Lifetime Prevalence Rate ◽  
Manual Review

Objective:To synthesize the available knowledge on cardiovascular and respiratory comorbidities in patients with bipolar disorder (BD).Methods:Relevant studies were identified by a MEDLINE search from 1966 to January 2008, and supplemented by a manual review of reference lists of the articles identified and previous review articles. When available, priority was given to comparative studies.Results:We identified 21 studies, 15 (71%) comparative. As compared to the general population, two studies reported higher point-prevalence rates of hypertension (28-60.8% vs 11.9-43%), two studies lower point-prevalence rates (10.4-34.8% vs 14.9-36.8%), one study a higher lifetime-prevalence rate (28.7% vs 14.8%), and one study a significantly increased incidence rate ratio (1.24 females and 1.34 for males). In addition, two studies reported higher point-prevalence rates of hypertension than in medical samples (4.6-18.1% vs 2.2-9.2%) and one study reported a higher risk than in patients with schizophrenia (OR 1.13, 95%CI 1.01-1.26). Point-prevalence rate of stroke was not different than in the general population (n=1, 1.7 vs 2.1, p=0.063); four studies evaluating the risk of stroke as compared to clinical samples provide contradictory results. Point-prevalence rates (n=2, 15.9-17% vs 8.3-10%) and lifetime-prevalence rate (n=1, 16.7% vs 9.7%) of asthma were higher than in the general population. Point-prevalence rates of COPD were also higher than in the general population (n=1, 10.6% vs 9.4%) and in clinical samples (n=3, 1-12.9% vs 0.6-3.6%).Conclusion:BD seems to be associated with increased rates of hypertension, asthma and COPD. Available data do not support the association between BD and stroke.

scholarly journals Fr011 RELATIONSHIP BETWEEN GASTROINTESTINAL MANIFESTATIONS AND CLINICAL OUTCOMES IN HOSPITALIZED PATIENTS WITH COVID-19 IN A COMMUNITY BASED HOSPITAL SYSTEM

2021 ◽  
Vol 160 (6) ◽  
pp. S-189
Author(s):  
Lynna Alnimer ◽  
Ali Zakaria ◽  
Christopher Hakim ◽  
Andrea R. Jamil ◽  
Kristina Ivezaj ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Hospitalized Patients ◽  
Community Based ◽  
Hospital System ◽  
Gastrointestinal Manifestations

scholarly journals Death, dying and bereavement care during COVID-19: Creativity in hospital social work practice

2021 ◽  
Vol 20 (1-2) ◽  
pp. 131-137
Author(s):  
Mim Fox ◽  
Joanna McIlveen ◽  
Elisabeth Murphy
Keyword(s):  
Social Work ◽  
Social Workers ◽  
Hospital Setting ◽  
Work Practice ◽  
Social Work Practice ◽  
Bereavement Support ◽  
Hospital System ◽  
Hospital Social Work ◽  
Complicating Factors ◽  
Bereavement Care

Bereavement support and conducting viewings for grieving family members are commonplace activities for social workers in the acute hospital setting, however the risks that COVID-19 has brought to the social work role in bereavement care has necessitated the exploration of creative alternatives. Social workers are acutely aware of the complicating factors when bereavement support is inadequately provided, let alone absent, and with the aid of technology and both individual advocacy, social workers have been able to continue to focus on the needs of the most vulnerable in the hospital system. By drawing on reflective journaling and verbal reflective discussions amongst the authors, this article discusses bereavement support and the facilitation of viewings as clinical areas in which hospital social work has been observed adapting practice creatively throughout the pandemic.

scholarly journals Household medication safety practices during the COVID-19 pandemic: a descriptive qualitative study protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e044441
Author(s):  
Tamasine C Grimes ◽  
Sara Garfield ◽  
Dervla Kelly ◽  
Joan Cahill ◽  
Sam Cromie ◽  
...  
Keyword(s):  
Social Media ◽  
Qualitative Study ◽  
Medication Safety ◽  
Best Practice ◽  
Public Involvement ◽  
Comparative Method ◽  
Patient And Public Involvement ◽  
Safety Practices ◽  
Trinity College Dublin ◽  
Descriptive Qualitative

IntroductionThose who are staying at home and reducing contact with other people during the COVID-19 pandemic are likely to be at greater risk of medication-related problems than the general population. This study aims to explore household medication practices by and for this population, identify practices that benefit or jeopardise medication safety and develop best practice guidance about household medication safety practices during a pandemic, grounded in individual experiences.Methods and analysisThis is a descriptive qualitative study using semistructured interviews, by telephone or video call. People who have been advised to ‘cocoon’/‘shield’ and/or are aged 70 years or over and using at least one long-term medication, or their caregivers, will be eligible for inclusion. We will recruit 100 patient/carer participants: 50 from the UK and 50 from Ireland. Recruitment will be supported by our patient and public involvement (PPI) partners, personal networks and social media. Individual participant consent will be sought, and interviews audio/video recorded and/or detailed notes made. A constructivist interpretivist approach to data analysis will involve use of the constant comparative method to organise the data, along with inductive analysis. From this, we will iteratively develop best practice guidance about household medication safety practices during a pandemic from the patient’s/carer’s perspective.Ethics and disseminationThis study has Trinity College Dublin, University of Limerick and University College London ethics approvals. We plan to disseminate our findings via presentations at relevant patient/public, professional, academic and scientific meetings, and for publication in peer-reviewed journals. We will create a list of helpful strategies that participants have reported and share this with participants, PPI partners and on social media.

scholarly journals 139. Impact of Pharmacist Driven Outpatient Fluoroquinolone Stewardship Initiative in Community Based Setting

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S81-S81
Author(s):  
Sarah Norman ◽  
Sara Jones ◽  
Cara Acklin ◽  
Christian Cheatham
Keyword(s):  
Antimicrobial Stewardship ◽  
Healthcare Providers ◽  
Hospital Setting ◽  
Secondary Outcome ◽  
Quality Improvement Initiative ◽  
Oral Antibiotic ◽  
Ambulatory Care Setting ◽  
Community Based ◽  
Before And After ◽  
Physician Network

Abstract Background Antimicrobial stewardship initiatives and efforts have historically had a greater emphasis in the inpatient hospital setting. There is a need for outpatient stewardship, and additionally, accreditation standards are starting to require antimicrobial stewardship efforts in the ambulatory care setting. Fluoroquinolones are a target for antimicrobial stewardship based on their broad-spectrum activity, pharmacokinetics/pharmacodynamics, safety profile, downstream resistance, and risk of super infections. The objective of this study was to compare outpatient fluoroquinolone prescribing rates before and after pharmacist led initiative. Methods This was a prospective, quality improvement initiative between October 1, 2019 to June 1, 2020 at a community-based physician network across Indiana. The pharmacist initiative incorporated a live, educational presentation with intervention 1 and an informational letter to healthcare providers across the outpatient physician network with intervention 2. Data was collected from a computer-generated, prescription report. The primary outcome was fluoroquinolone prescribing rates at Central Indiana (CI) sites before and after pharmacist led interventions. Rate of fluoroquinolone prescribing was defined as total number of fluoroquinolone prescriptions per month. The secondary outcome included percentage of fluoroquinolone use at CI sites. Percentage of fluoroquinolone use was defined as monthly number of fluoroquinolones prescriptions compared to monthly number of all oral antibiotic prescriptions. Results There was a 29.8% decrease (382 vs 268 prescriptions) in outpatient fluoroquinolone prescriptions at CI sites after intervention 1 compared to same month of previous year. There was a 43.7% decrease (428 vs 241 prescriptions) in outpatient fluoroquinolone prescriptions at CI sites after intervention 2. There was an overall 2.4% decrease (4.9% vs 2.5%) in percentage of fluoroquinolone use compared to all oral antibiotics at CI sites after intervention 2 compared to same month of previous year. Conclusion These findings suggest the pharmacist led outpatient antimicrobial stewardship initiative successfully decreased fluoroquinolone prescribing rates across the network. Disclosures Christian Cheatham, PharmD, BCIDP, Antimicrobial Resistance Solutions (Shareholder)

scholarly journals Chronic polytherapy after myocardial infarction: the trade-off between hospital and community-based providers in determining adherence to medication

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mirko Di Martino ◽  
Michela Alagna ◽  
Adele Lallo ◽  
Kendall Jamieson Gilmore ◽  
Paolo Francesconi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Medication Adherence ◽  
Geographic Variation ◽  
Best Practice ◽  
Multilevel Models ◽  
Medication Possession Ratio ◽  
Coronary Intervention ◽  
Community Based ◽  
Optimal Care ◽  
Adherence To Medication

Abstract Background The benefits of chronic polytherapy in reducing readmissions and death after myocardial infarction (MI) have been clearly shown. However, real-world evidence shows poor medication adherence and large geographic variation, suggesting critical issues in access to optimal care. Our objectives were to measure adherence to polytherapy, to compare the amount of variation attributable to hospitals of discharge and to community-based providers, and to identify determinants of adherence to medications. Methods This is a population-based study. Data were obtained from the information systems of the Lazio and Tuscany Regions, Italy (9.5 million inhabitants). Patients hospitalized with incident MI in 2010–2014 were analyzed. The outcome measure was medication adherence, defined as a Medication Possession Ratio (MPR) ≥ 0.75 for at least 3 of the following drugs: antiplatelets, β-blockers, ACEI/ARBs, statins. A 2-year cohort-study was performed. Cross-classified multilevel models were applied to analyze geographic variation. The variance components attributable to hospitals of discharge and community-based providers were expressed as Median Odds Ratio (MOR). Results A total of 32,962 patients were enrolled. About 63% of patients in the Lazio cohort and 59% of the Tuscan cohort were adherent to chronic polytherapy. Women and patients aged 85 years and over were most at risk of non-adherence. In both regions, adherence was higher for patients discharged from cardiology wards (Lazio: OR = 1.58, p < 0.001, Tuscany: OR = 1.59, p < 0.001) and for patients with a percutaneous coronary intervention during the index admission. Relevant variation between community-based providers was observed, though when the hospital of discharge was included as a cross-classified level, in both Lazio and Tuscany regions the variation attributable to hospitals of discharge was the only significant component (Lazio: MOR = 1.30, p = 0.001; Tuscany: MOR = 1.31, p = 0.001). Conclusion Adherence to best practice treatments after MI is not consistent with clinical guidelines, and varies between patient groups as well as within and between regions. The variation attributable to providers is affected by the hospital of discharge, up to two years from the acute episode. This variation is likely to be attributable to hospital discharge processes, and could be reduced through appropriate policy levers.

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