TY - JOUR
T1 - Documentation of Indications
T2 - Agreement Between Order Entry and Clinical Notes and Effect on Time to Antibiotic Administration
AU - Scardina, Tonya
AU - Stach, Leslie
AU - Sun, Shan
AU - Kociolek, Larry Kenneth
AU - Reuter, Caroline
AU - Vogt, Michael
AU - Patel, Sameer
PY - 2020
Y1 - 2020
N2 - Background/Objectives: Antibiotic indication documentation at the time of order entry is mandated by the Joint Commission. Inclusion of indication at order entry may have an impact on the time to administration. Our primary objective was to evaluate agreement between indication selected during order entry and clinical notes. Our secondary objective was to observe if there was a change in time to administration after indications were required during order entry. Methods: Patients ≤18 years old who received ≥1 dose of vancomycin or ceftriaxone during a preintervention period and 3 postintervention periods were included. Indication for use, agreement between order and clinical note, and timing of antibiotic administration were collected. Results: Most common indication for vancomycin (total: 789) was sepsis (26%, n = 204). Common indications for ceftriaxone (total: 1071) were sepsis (12%, n = 127), perforated appendicitis (12%, n = 125), and urinary tract infection (10%, n = 107). Postintervention, agreement between the indication selected during order entry and indication documented in clinical note for ceftriaxone and vancomycin orders were 41% and 46%, respectively. Median time to administration decreased among patients who received ceftriaxone (P <.01) but had no significant impact on time to administration of vancomycin (P =.49). Conclusions: Indication for ceftriaxone and vancomycin selected during order entry and reported in clinical notes inconsistently matched. Inclusion of antibiotic indication may impact time to administration.
AB - Background/Objectives: Antibiotic indication documentation at the time of order entry is mandated by the Joint Commission. Inclusion of indication at order entry may have an impact on the time to administration. Our primary objective was to evaluate agreement between indication selected during order entry and clinical notes. Our secondary objective was to observe if there was a change in time to administration after indications were required during order entry. Methods: Patients ≤18 years old who received ≥1 dose of vancomycin or ceftriaxone during a preintervention period and 3 postintervention periods were included. Indication for use, agreement between order and clinical note, and timing of antibiotic administration were collected. Results: Most common indication for vancomycin (total: 789) was sepsis (26%, n = 204). Common indications for ceftriaxone (total: 1071) were sepsis (12%, n = 127), perforated appendicitis (12%, n = 125), and urinary tract infection (10%, n = 107). Postintervention, agreement between the indication selected during order entry and indication documented in clinical note for ceftriaxone and vancomycin orders were 41% and 46%, respectively. Median time to administration decreased among patients who received ceftriaxone (P <.01) but had no significant impact on time to administration of vancomycin (P =.49). Conclusions: Indication for ceftriaxone and vancomycin selected during order entry and reported in clinical notes inconsistently matched. Inclusion of antibiotic indication may impact time to administration.
KW - antibiotic indications
KW - antimicrobial stewardship
KW - computer physician order entry
KW - pediatric infectious diseases
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U2 - 10.1177/0897190020938225
DO - 10.1177/0897190020938225
M3 - Article
C2 - 32643519
AN - SCOPUS:85087666718
JO - Journal of Pharmacy Practice
JF - Journal of Pharmacy Practice
SN - 0897-1900
ER -