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Prevention of adverse events in hospitalized patients using an antimicrobial review program
B J Guglielmo1, A D Luber, R L Corelli
1Department of Clinical Pharmacy, School of Pharmacy, University of California at San Francisco 94143-0622, USA. bjg@itsa.ucsf.edu
Objective:
To evaluate whether an antimicrobial review system is associated with a reduction in antimicrobial-associated adverse events.
Design:
All antimicrobial medication orders for patients hospitalized over a two-year period were evaluated. High-level interventions intended to prevent adverse antimicrobial events were collated. Based on literature estimates of adverse antimicrobial events, potential reduction of high-level adverse antimicrobial events was estimated.
Setting:
Department of Clinical Pharmacy and Division of Infectious Diseases at a tertiary care teaching hospital.
Results:
A total of 452 interventions were classified as "high-level." The incidence of preventable adverse antimicrobial events requiring intervention was 16 per 1000 antimicrobial orders. The incidence of high-level errors necessitating intervention was 4.4 per 1000 antimicrobial orders. An estimated 125 to 198 high-level adverse events were avoided.
Conclusion:
An antimicrobial review program has the potential to reduce significant adverse events in hospitalized patients.
Insights
An antimicrobial review system can significantly reduce adverse drug events in hospitalized patients. This system helps prevent serious complications associated with antimicrobial use.
Area of Science:
- Clinical Pharmacy
- Infectious Diseases
- Patient Safety
Background:
- Antimicrobial-associated adverse events pose a significant risk to hospitalized patients.
- Effective review systems are crucial for mitigating these risks.
- Previous literature highlights the potential for interventions to prevent adverse events.
Purpose of the Study:
- To determine if an antimicrobial review system is linked to a decrease in antimicrobial-associated adverse events.
- To quantify the impact of a review system on patient safety.
- To assess the effectiveness of high-level interventions in preventing adverse events.
Main Methods:
- A two-year evaluation of all antimicrobial medication orders in a tertiary care hospital.
- Collated high-level interventions aimed at preventing adverse antimicrobial events.
- Estimated potential reduction in high-level adverse antimicrobial events based on literature.
Main Results:
- 452 high-level interventions were identified.
- The incidence of preventable adverse antimicrobial events was 16 per 1000 orders.
- High-level errors requiring intervention occurred at 4.4 per 1000 orders, with an estimated 125-198 events avoided.
Conclusions:
- An antimicrobial review program demonstrates potential for reducing significant adverse events in hospitalized patients.
- Implementation of such programs can enhance patient safety and optimize antimicrobial therapy.
- The findings support the integration of review systems into clinical practice.