Optimizing the correct timing of vancomycin level collection utilizing a vancomycin medication administration record...

Area of Science:

• Pharmacology
• Clinical Pharmacy
• Health Informatics

Background:

• Vancomycin, a critical antibiotic, necessitates Therapeutic Drug Monitoring (TDM) due to its narrow therapeutic index.
• Electronic Medical Records (EMR) can inadvertently lead to inaccurate vancomycin levels if not optimized.
• The Medication Administration Record (MAR) is integral to nursing medication workflows.

Purpose of the Study:

• To evaluate the impact of a MAR level order integrated into the EMR on the accuracy of vancomycin level collection.
• To determine if this intervention reduces the rate of incorrectly drawn vancomycin levels.

Main Methods:

• A multicenter, retrospective, pre- and post-intervention study design was employed.
• Vancomycin levels were analyzed before and after the implementation of the MAR level order.
• Incorrectly drawn levels were defined as early, late, during infusion, or missed collections.

Main Results:

• The post-intervention group using the MAR level order showed a significant decrease in incorrectly drawn vancomycin levels (11.1% vs. 36%, P < 0.01).
• The rate of missed or incorrectly timed levels was substantially lower in the intervention group.
• Rescheduling of vancomycin levels also decreased significantly post-intervention (3.4% vs. 8.5%, P < 0.01).

Conclusions:

• Integrating a vancomycin MAR level order into the EMR workflow is effective in reducing incorrectly drawn levels.
• This intervention enhances the reliability of Therapeutic Drug Monitoring for vancomycin.
• Optimizing EMR workflows through MAR level orders improves vancomycin level collection accuracy.