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Dee AA, Kelly B, Hampp C. Root cause analysis and subsequent intervention to improve first dose antibiotic turnaround time for hospitalized pediatric patients. J Pediatr Pharmacol Ther. 2010;15(3):182-8
Dee, A. A., Kelly, B., & Hampp, C. (2010). Root cause analysis and subsequent intervention to improve first dose antibiotic turnaround time for hospitalized pediatric patients. The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG, 15(3), 182-8.
Dee, Abigail A, et al. "Root cause analysis and subsequent intervention to improve first dose antibiotic turnaround time for hospitalized pediatric patients." The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG vol. 15,3 (2010): 182-8.
Dee AA, Kelly B, Hampp C. Root cause analysis and subsequent intervention to improve first dose antibiotic turnaround time for hospitalized pediatric patients. J Pediatr Pharmacol Ther. 2010 Jul;15(3):182-8. PMID: 22477810; PMCID: PMC3018248.
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J Pediatr Pharmacol Ther. 2010 Jul;15(3):182-8.

Root cause analysis and subsequent intervention to improve first dose antibiotic turnaround time for hospitalized pediatric patients.

The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG

Abigail A Dee, Brian Kelly, Christian Hampp

Affiliations

  1. Shands at the University of Florida, Gainesville, Florida.

PMID: 22477810 PMCID: PMC3018248

Abstract

OBJECTIVE: Antibiotic timing is used as a quality standard for hospital accreditation and is an important quality measure. The study aim was to identify barriers in the process of first dose antibiotic administration on the pediatric floors at a tertiary healthcare center and carry out and test an intervention to improve turnaround time to less than one hour.

METHODS: We conducted a quasi-experimental pre-post study of hospitalized pediatric patients up to 18 years of age initiated on intravenous antibiotics. Every order for a first dose intravenous antibiotic was assessed on all pediatric floors (10/2008). Orders that did not meet the overall turnaround time goal of ≤ 1 hour were identified. A root cause analysis (RCA) was performed to identify reasons for delayed antibiotic administration. Barriers identified in the RCA were used to develop interventions (03/2009) to improve compliance, and the proportion of orders that met the goal was compared pre- (10/2008-02/2009) and post-intervention (04/2009-05/2009).

RESULTS: During the pre-intervention assessment period, 32 out of 46 total physician orders for a first dose intravenous antibiotic did not meet the one-hour overall turnaround goal. A main reason for delay was failure to label antibiotic orders as first dose. We designed an intervention that included antibiotic audits and individualized feedback to prescribers. The mean ± SD time from the written physician order to drug administration was 228 ± 58 minutes; timing improved to 55 ± 4 minutes after the intervention. The proportion of antibiotics administered within one hour improved from 42.2% to 63% (p=0.0015).

CONCLUSIONS: We identified system barriers associated with delayed antibiotic administration. Antibiotic timing was improved after continued surveillance and individualized feedback to providers.

References

  1. JAMA. 2007 Apr 25;297(16):1758-9 - PubMed
  2. Med Care. 2004 Jul;42(7):643-8 - PubMed
  3. Arch Intern Med. 2004 Jun 14;164(11):1206-12 - PubMed
  4. Arch Intern Med. 2004 Mar 22;164(6):637-44 - PubMed
  5. Ann Intern Med. 2008 Jul 1;149(1):29-32 - PubMed

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