Arnold and Marie Schwartz College of Pharmacy, Long Island University, Brooklyn, NY, USA.
Department of Pharmacy, Mount Sinai Queens, Astoria, NY, USA.
J Pharm Pract. 2024 Apr;37(2):335-342. doi: 10.1177/08971900221134648. Epub 2022 Oct 19.
Antimicrobial stewardship program implementation at non-teaching community hospitals differs due to staffing and resource disparities. Demonstrate that an infectious disease (ID) pharmacist faculty with advanced pharmacy practice experience (APPE) students can expand antimicrobial stewardship services at non-teaching community hospitals. A single-center, retrospective chart review was conducted comparing prospective audit and feedback antimicrobial stewardship interventions by an ID pharmacist faculty with and without APPE students between January 16, 2020 to January 16, 2021. The primary endpoints were intervention rate and the intervention acceptance rate. Secondary endpoints included: the difference in the time from antimicrobial order to intervention and length of stay, as well as comparison of acceptance rates stratified by intervention type or the antimicrobial intervened upon. A total of 739 antimicrobial stewardship interventions were made with an overall acceptance rate of 55.2%. The ID pharmacist faculty with APPE students had a higher number of interventions and intervention rate per working day compared to without students (428 vs 311 and 4.46 vs 2.99, respectively). Conversely, the intervention acceptance rate was lower for the ID pharmacist faculty with APPE students vs without (48.8% vs 64%, P < .001). Both the median time from antimicrobial order to the intervention and length of stay was lower for the ID pharmacist faculty with students vs without (2.50 days [interquartile range (IQR) 1.24 - 4.01] vs 2.99 days [IQR 1.64 - 4.95], P = .003, and 9.20 days [IQR 5.57 - 14.93] vs 11.69 days [IQR 6.89 - 22.31], P < .001, respectively). The acceptance rates by intervention type and the antimicrobial intervened upon were similar between groups. An ID pharmacist faculty with APPE students at a non-teaching community hospital increased the number of stewardship interventions, and was associated with decreased time from antimicrobial order to intervention and length of stay.
非教学社区医院的抗菌药物管理计划实施因人员配备和资源差异而有所不同。证明具有高级实践经验(APPE)的传染病(ID)药剂师教职员工可以扩大非教学社区医院的抗菌药物管理服务。对 2020 年 1 月 16 日至 2021 年 1 月 16 日期间,一名 ID 药剂师教职员工与没有 APPE 学生的情况下进行的前瞻性审核和反馈抗菌药物管理干预进行了单中心回顾性图表审查。主要终点是干预率和干预接受率。次要终点包括:从抗菌药物医嘱到干预的时间差异和住院时间,以及按干预类型或干预的抗菌药物对接受率进行分层的比较。共进行了 739 次抗菌药物管理干预,总体接受率为 55.2%。有 APPE 学生的 ID 药剂师教职员工的干预次数和每个工作日的干预率均高于没有学生的教职员工(分别为 428 次与 311 次,4.46 次与 2.99 次)。相反,有 APPE 学生的 ID 药剂师教职员工的干预接受率低于没有学生的教职员工(分别为 48.8%与 64%,P<.001)。有学生的 ID 药剂师教职员工与没有学生的教职员工相比,从抗菌药物医嘱到干预的中位时间和住院时间更短(分别为 2.50 天[四分位距(IQR)1.24-4.01]与 2.99 天[IQR 1.64-4.95],P=0.003 和 9.20 天[IQR 5.57-14.93]与 11.69 天[IQR 6.89-22.31],P<.001)。干预类型和干预的抗菌药物的接受率在两组之间相似。非教学社区医院中,有 APPE 学生的 ID 药剂师教职员工增加了管理干预的数量,并且与从抗菌药物医嘱到干预的时间和住院时间缩短有关。