Impact of a Multidisciplinary Bundle on Time to Antibiotic Administration in Septic SICU Patients

被引：9

作者：

Almalki, Ohoud ^{[1
]}

Levine, Alexander R. ^{[2
]}

Turner, Elizabeth ^{[3
]}

Newman, Kelly ^{[1
]}

DeMoya, Marc ^{[3
]}

Lee, Jarone ^{[4
]}

Bittner, Edward A. ^{[5
]}

Lin, Hsin ^{[1
]}

机构：

[1] Massachusetts Gen Hosp, Dept Pharm, 55 Fruit St, Boston, MA 02114 USA

[2] Univ St Joseph, Dept Pharm Practice & Adm, Sch Pharm, Hartford, CT USA

[3] Massachusetts Gen Hosp, Div Trauma Emergency Surg & Surg Crit Care, Boston, MA 02114 USA

[4] Massachusetts Gen Hosp, Dept Surg & Emergency Med, Boston, MA 02114 USA

[5] Massachusetts Gen Hosp, Dept Anesthesia Crit Care & Pain Med, Boston, MA 02114 USA

来源：

JOURNAL OF INTENSIVE CARE MEDICINE | 2017年 / 32卷 / 08期

关键词：

sepsis; quality; multidisciplinary critical care; SEVERE SEPSIS; UNITED-STATES; SHOCK; MANAGEMENT; SURVIVAL; THERAPY;

D O I：

10.1177/0885066616656344

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Purpose: The goal of this study was to investigate barriers to timely antibiotic administration in septic surgical intensive care unit (SICU) patients and examine the impact of a multidisciplinary bundle on the time from prescription to antibiotic administration. Methods: This was a pre- and postintervention study that consisted of 3 phases: (1) preintervention phase, retrospective evaluation of data, (2) intervention implementation, and (3) a postintervention phase. A nurse survey was conducted to identify barriers to rapid antibiotic administration during phase 1. Based on this survey, multidisciplinary interventions included adding antibiotics to the automatic dispensing cabinet, educating monthly staff, and providing an antibiotic dosing table to all prescribers, which is attached to the computer workstations. Our multidisciplinary team consisted of the ICU medical directors, nurse managers, nurses, a critical care fellow, and ICU pharmacists. Results: The percentage of antibiotics that were received within 60 minutes was 26.3% in the pregroup versus 84.0% in the postgroup (P < .001). The mean total prescriber to patient time was 110 minutes in the pregroup versus 58.4 minutes in the postgroup (P < .001). Conclusion: We achieved a higher rate of timely antibiotic administration among septic SICU patients by implementing process changes based on barriers identified by the nurses.

引用

页码：494 / 499

页数：6

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