Factors associated with adherence to antimicrobial stewardship after-hours

Mona Mostaghim, Thomas Snelling, Beata Bajorek

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Objectives: Assess restricted antimicrobials acquired after standard working hours for adherence to antimicrobial stewardship (AMS) and identify factors associated with increased likelihood of adherence at the time of acquisition, and the next standard working day.

    Methods: All documented antimicrobials acquired from a paediatric hospital after-hours drug room from 1 July 2014 to 30 June 2015 were reconciled with records of AMS approval, and documented AMS review in the medical record.

    Key findings: Of the 758 antimicrobial acquisitions from the after-hours drug room, 62.3% were restricted. Only 29% were AMS adherent at the time of acquisition, 15% took place despite documented request for approval by a pharmacist. Antimicrobials for respiratory patients (OR 3.10, 95% CI 1.68–5.5) and antifungals (2.48, 95% CI 1.43–4.30) were more likely to be AMS adherent. Half of the acquisitions that required review the next standard working day were adherent to AMS (51.8%, 129/249). Weekday acquisitions (2.10, 95% CI 1.20–3.69) and those for patients in paediatric intensive care (2.26, 95% CI 1.07–4.79) were associated with AMS adherence. Interactions with pharmacists prior to acquisition did not change the likelihood of AMS adherence the next standard working day. Access to restricted antimicrobial held as routine ward stock did not change the likelihood of AMS adherence at the time of acquisition, or the next standard working day.

    Conclusion: Restricted antimicrobials acquired after-hours are not routinely AMS adherent at the time of acquisition or the next standard working day, limiting opportunities for AMS involvement.

    Original languageEnglish
    Pages (from-to)180-190
    Number of pages11
    JournalInternational Journal of Pharmacy Practice
    Volume27
    Issue number2
    Early online date3 Oct 2018
    DOIs
    Publication statusPublished - Apr 2019

    Fingerprint

    Pediatrics
    Pharmacists
    Pediatric Hospitals
    Critical Care
    Pharmaceutical Preparations
    Medical Records

    Cite this

    Mostaghim, Mona ; Snelling, Thomas ; Bajorek, Beata. / Factors associated with adherence to antimicrobial stewardship after-hours. In: International Journal of Pharmacy Practice. 2019 ; Vol. 27, No. 2. pp. 180-190.
    @article{6fdc2ad9db5f49c6a8756031f9992063,
    title = "Factors associated with adherence to antimicrobial stewardship after-hours",
    abstract = "Objectives: Assess restricted antimicrobials acquired after standard working hours for adherence to antimicrobial stewardship (AMS) and identify factors associated with increased likelihood of adherence at the time of acquisition, and the next standard working day. Methods: All documented antimicrobials acquired from a paediatric hospital after-hours drug room from 1 July 2014 to 30 June 2015 were reconciled with records of AMS approval, and documented AMS review in the medical record. Key findings: Of the 758 antimicrobial acquisitions from the after-hours drug room, 62.3{\%} were restricted. Only 29{\%} were AMS adherent at the time of acquisition, 15{\%} took place despite documented request for approval by a pharmacist. Antimicrobials for respiratory patients (OR 3.10, 95{\%} CI 1.68–5.5) and antifungals (2.48, 95{\%} CI 1.43–4.30) were more likely to be AMS adherent. Half of the acquisitions that required review the next standard working day were adherent to AMS (51.8{\%}, 129/249). Weekday acquisitions (2.10, 95{\%} CI 1.20–3.69) and those for patients in paediatric intensive care (2.26, 95{\%} CI 1.07–4.79) were associated with AMS adherence. Interactions with pharmacists prior to acquisition did not change the likelihood of AMS adherence the next standard working day. Access to restricted antimicrobial held as routine ward stock did not change the likelihood of AMS adherence at the time of acquisition, or the next standard working day. Conclusion: Restricted antimicrobials acquired after-hours are not routinely AMS adherent at the time of acquisition or the next standard working day, limiting opportunities for AMS involvement.",
    keywords = "anti-infectives, clinical pharmacy, clinical practice, clinical topics, decision aids, drug utilisation, evidence based practice, medication review, ward pharmacy",
    author = "Mona Mostaghim and Thomas Snelling and Beata Bajorek",
    year = "2019",
    month = "4",
    doi = "10.1111/ijpp.12486",
    language = "English",
    volume = "27",
    pages = "180--190",
    journal = "International Journal of Pharmacy Practice",
    issn = "0961-7671",
    publisher = "Wiley-Blackwell",
    number = "2",

    }

    Factors associated with adherence to antimicrobial stewardship after-hours. / Mostaghim, Mona; Snelling, Thomas; Bajorek, Beata.

    In: International Journal of Pharmacy Practice, Vol. 27, No. 2, 04.2019, p. 180-190.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Factors associated with adherence to antimicrobial stewardship after-hours

    AU - Mostaghim, Mona

    AU - Snelling, Thomas

    AU - Bajorek, Beata

    PY - 2019/4

    Y1 - 2019/4

    N2 - Objectives: Assess restricted antimicrobials acquired after standard working hours for adherence to antimicrobial stewardship (AMS) and identify factors associated with increased likelihood of adherence at the time of acquisition, and the next standard working day. Methods: All documented antimicrobials acquired from a paediatric hospital after-hours drug room from 1 July 2014 to 30 June 2015 were reconciled with records of AMS approval, and documented AMS review in the medical record. Key findings: Of the 758 antimicrobial acquisitions from the after-hours drug room, 62.3% were restricted. Only 29% were AMS adherent at the time of acquisition, 15% took place despite documented request for approval by a pharmacist. Antimicrobials for respiratory patients (OR 3.10, 95% CI 1.68–5.5) and antifungals (2.48, 95% CI 1.43–4.30) were more likely to be AMS adherent. Half of the acquisitions that required review the next standard working day were adherent to AMS (51.8%, 129/249). Weekday acquisitions (2.10, 95% CI 1.20–3.69) and those for patients in paediatric intensive care (2.26, 95% CI 1.07–4.79) were associated with AMS adherence. Interactions with pharmacists prior to acquisition did not change the likelihood of AMS adherence the next standard working day. Access to restricted antimicrobial held as routine ward stock did not change the likelihood of AMS adherence at the time of acquisition, or the next standard working day. Conclusion: Restricted antimicrobials acquired after-hours are not routinely AMS adherent at the time of acquisition or the next standard working day, limiting opportunities for AMS involvement.

    AB - Objectives: Assess restricted antimicrobials acquired after standard working hours for adherence to antimicrobial stewardship (AMS) and identify factors associated with increased likelihood of adherence at the time of acquisition, and the next standard working day. Methods: All documented antimicrobials acquired from a paediatric hospital after-hours drug room from 1 July 2014 to 30 June 2015 were reconciled with records of AMS approval, and documented AMS review in the medical record. Key findings: Of the 758 antimicrobial acquisitions from the after-hours drug room, 62.3% were restricted. Only 29% were AMS adherent at the time of acquisition, 15% took place despite documented request for approval by a pharmacist. Antimicrobials for respiratory patients (OR 3.10, 95% CI 1.68–5.5) and antifungals (2.48, 95% CI 1.43–4.30) were more likely to be AMS adherent. Half of the acquisitions that required review the next standard working day were adherent to AMS (51.8%, 129/249). Weekday acquisitions (2.10, 95% CI 1.20–3.69) and those for patients in paediatric intensive care (2.26, 95% CI 1.07–4.79) were associated with AMS adherence. Interactions with pharmacists prior to acquisition did not change the likelihood of AMS adherence the next standard working day. Access to restricted antimicrobial held as routine ward stock did not change the likelihood of AMS adherence at the time of acquisition, or the next standard working day. Conclusion: Restricted antimicrobials acquired after-hours are not routinely AMS adherent at the time of acquisition or the next standard working day, limiting opportunities for AMS involvement.

    KW - anti-infectives

    KW - clinical pharmacy

    KW - clinical practice

    KW - clinical topics

    KW - decision aids

    KW - drug utilisation

    KW - evidence based practice

    KW - medication review

    KW - ward pharmacy

    UR - http://www.scopus.com/inward/record.url?scp=85054357594&partnerID=8YFLogxK

    U2 - 10.1111/ijpp.12486

    DO - 10.1111/ijpp.12486

    M3 - Article

    VL - 27

    SP - 180

    EP - 190

    JO - International Journal of Pharmacy Practice

    JF - International Journal of Pharmacy Practice

    SN - 0961-7671

    IS - 2

    ER -