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Vancomycin administration: the impact of multidisciplinary interventions
R K Crowley1, F Fitzpatrick, D Solanki
1Department of Clinical Microbiology, Beaumont Hospital, Dublin, Ireland. rachelcrowley@beaumont.ie
Journal of Clinical Pathology
|February 13, 2007
Summary
Interventions significantly reduced vancomycin dose omissions by 37.5% over one year. However, 10% of vancomycin doses were still inappropriately held, highlighting challenges in healthcare behavior change.
Area of Science:
- Clinical Pharmacy
- Pharmacokinetics
- Healthcare Quality Improvement
Background:
- Patients frequently missed prescribed vancomycin doses.
- Ward staff struggled with ordering and interpreting vancomycin therapeutic drug monitoring (TDM).
Purpose of the Study:
- Audit vancomycin dose omission incidence.
- Implement interventions to improve vancomycin administration.
- Re-audit to assess intervention effectiveness.
Main Methods:
- Conducted three prospective audits on vancomycin TDM impact.
- Implemented process changes and interpretative charts.
- Provided feedback and planned ongoing education.
Main Results:
- Inappropriately held vancomycin doses reduced from 16% to 10%.
- Doses held for no apparent reason decreased significantly.
- A 37.5% reduction in inappropriately held doses was observed.
Conclusions:
- Interventions led to a substantial decrease in missed vancomycin doses.
- Persistent challenges remain in modifying healthcare worker behavior.
- Ongoing education and process refinement are crucial for sustained improvement.
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