Implementation of antimicrobial stewardship weekend coverage within a community hospital with a PGY-2 infectious...

The goal of this study was to describe the impact of expanding inpatient ASP weekend coverage with a newly established infectious diseases postgraduate second-year (ID-PGY-2) pharmacy residency program through quantification of inpatient ASP interventions. Secondary end points included comparing weekend stewardship activities before and after an ID-PGY-2 incorporated staffing model shift based on intervention quantity, type, and impact to weekends.

This retrospective cohort study was conducted evaluating weekend Antimicrobial stewardship program (ASP) interventions documented within the electronic health record between July 1, 2021, and December 31, 2022. Groups included a single clinical pharmacist, 2 new postgraduate first-year (PGY-1) pharmacy residents, 2 experienced PGY-1 pharmacy residents, and an ID-PGY-2 responsible only for ASP coverage.

Eight weekends of interventions were collected per group. The median (interquartile range [IQR]) number of ASP interventions per weekend increased during ID-PGY-2 resident weekends (34 [28.75-35]) compared to a clinical pharmacist alone (5 [4-10], P < 0.001), and both new (2.5 [1.25-4], P < 0.001) and experienced (6 [3.5-10.5], P < 0.001) PGY-1 resident groups. The ID-PGY-2 resident initiated statistically significantly more interventions per protocol and interventions requiring communication with providers. The acceptance rate for interventions made via communication was similar between groups (ID-PGY-2 86.3% vs. clinical pharmacist 87.7% vs. new PGY-1 100% vs. experienced PGY-1 90.5%, P = 0.541).

Expansion of ASP services to include weekend clinical coverage with an ID-PGY-2 pharmacy resident significantly increased weekend ASP interventions in a community teaching hospital.