Emergency Pharmacist Impact on Health Care-Associated Pneumonia Empiric Therapy

DeFrates, Sean; Weant, Kyle A.; Seamon, Jason P.; Shirakbari, Alicia; Baker, Stephanie N.

doi:10.1177/0897190012451933

Cited by 24 publications

(28 citation statements)

References 21 publications

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“…Several studies have evaluated the effects of an EMP on patient outcomes. A retrospective chart review of adult patients presenting to the ED with health care‐associated pneumonia found that patients presenting within the EMP's hours were significantly more likely to receive guideline‐appropriate antibiotic therapy . Patients presenting during the EMP's hours also received antibiotics in a shorter amount of time and at more appropriate doses, although these outcomes were not statistically significant .…”

Section: Discussionmentioning

confidence: 99%

“…A retrospective chart review of adult patients presenting to the ED with health care-associated pneumonia found that patients presenting within the EMP's hours were significantly more likely to receive guideline-appropriate antibiotic therapy. 12 Patients presenting during the EMP's hours also received antibiotics in a shorter amount of time and at more appropriate doses, although these outcomes were not statistically significant. 12 Our study sought to elaborate on these findings and found that patients presenting during the time that an EMP was present were significantly more likely to receive guidelineappropriate antibiotic therapy.…”

Section: Secondary Outcomesmentioning

confidence: 93%

“…12 Patients presenting during the EMP's hours also received antibiotics in a shorter amount of time and at more appropriate doses, although these outcomes were not statistically significant. 12 Our study sought to elaborate on these findings and found that patients presenting during the time that an EMP was present were significantly more likely to receive guidelineappropriate antibiotic therapy. The indication for almost all patients in the current study who received antibiotic therapy during their CCA encounter was open fracture prophylaxis; therefore, the appropriateness of empiric antibiotics was based on the EAST guidelines.…”

Section: Secondary Outcomesmentioning

confidence: 93%

“…The first descriptions of clinical pharmacy services in the emergency department (ED) occurred in the 1970s with a primary focus on medication distribution . The role of the emergency medicine pharmacist (EMP) has since expanded to involve a variety of services, including direct patient care rounds, medication order review, medication therapy monitoring, and management of high‐risk medications as well as participating in procedures, antimicrobial stewardship, medication information, medication procurement and preparation, and resuscitation …”

Section: Introductionmentioning

confidence: 99%

“…1-17The EMP plays a critical role in the care of patients presenting with multiple acute disease states, as demonstrated by the current literature. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Pharmacists have been shown to decrease the time to percutaneous coronary intervention (PCI) for patients presenting with acute ST elevation myocardial infarction (STEMI), decrease the time to sedation and analgesia following rapid sequence intubation (RSI), facilitate the procurement of health care-associated appropriate antibiotic therapy, and reduce medication discrepancies and errors through medication reconciliation in the ED.While much evidence exists detailing the impact of EMPs on patient outcomes and cost-avoidance, there is a dearth of studies that…”

mentioning

confidence: 99%

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Implications of the presence of an emergency medicine pharmacist during critical care trauma patient resuscitation

Lamkin

Lindsey

Weant

et al. 2019

J Am Coll Clin Pharm

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Purpose The available literature has shown that the presence of an Emergency Medicine Pharmacist (EMP) is associated with decreased time to medication procurement, a reduction in medication errors, and overall cost avoidance. However, there is limited literature that systematically evaluates the impact of EMPs in the treatment of critically ill trauma patients presenting to the emergency department (ED). Methods This study was a retrospective chart review evaluating 1082 adult patients presenting to the critical care area (CCA) of the ED at the University of Louisville Hospital in Louisville, Kentucky for trauma evaluation from July 2014 to December 2014. The study group consisted of patients presenting to the CCA when an EMP was present. Primary outcomes included time to administration of antibiotics, analgesia medication, sedation medication, rapid sequence intubation (RSI), and anticoagulation reversal. Secondary outcomes included time to administration of appropriate antibiotics at an appropriate dose and vaccination administration. Results The presence of an EMP was associated with a statistically significant decreased median time from triage to the administration of an analgesic medication (11 minutes [interquartile range (IQR) 8‐27] vs 13 minutes [IQR 8.5‐20], P = 0.04). There was no statistically significant difference in triage time to antibiotic administration, RSI, sedation medication administration, or anticoagulation reversal. Patients in the EMP group were more likely to receive appropriate empiric antibiotics compared with the control group (80.7% vs 52.2%, P = 0.01). Conclusion The presence of an EMP was associated with decreased time to analgesia medication administration as well as an increased likelihood of the administration of appropriate empiric antibiotics in critically ill trauma patients.

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Section: Discussionmentioning

confidence: 99%

Section: Secondary Outcomesmentioning

confidence: 93%

Section: Secondary Outcomesmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Implications of the presence of an emergency medicine pharmacist during critical care trauma patient resuscitation

Lamkin

Lindsey

Weant

et al. 2019

J Am Coll Clin Pharm

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Standard of practice in emergency medicine for pharmacy services

Welch

Currey

Doran

et al. 2019

Pharmacy Practice and Res

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The Need forPGY2‐Trained Clinical Pharmacy Specialists

et al. 2014

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The American College of Clinical Pharmacy and other stakeholder organizations seek to advance clinical pharmacist practitioners, educators, and researchers. Unfortunately, there remains an inadequate supply of residency-trained clinical specialists to meet the needs of our health care system, and nonspecialists often are called on to fill open specialist positions. The impact of clinical pharmacy specialists on pharmacotherapy outcomes in both acute care and primary care settings demonstrates the value of these specialists. This commentary articulates the need for postgraduate year two (PGY2)-trained clinical specialists within the health care system by discussing various clinical and policy rationales, interprofessional support, economic justifications, and their impact on quality of care and drug safety. The integrated practice model that has grown out of the American Society of Health-System Pharmacists Pharmacy Practice Model Initiative (PPMI) could threaten the growth and development of future clinical specialists. Therefore, the ways in which PGY2-trained clinical pharmacist specialists are deployed in the PPMI require further consideration. PGY2 residencies provide education and training opportunities that cannot be achieved in traditional professional degree programs or postgraduate year one residencies. These specialists are needed to provide direct patient care to complex patient populations and to educate and train pharmacy students and postgraduate residents. Limitations to training and hiring PGY2-trained clinical pharmacy specialists include site capacity limitations and lack of funding. A gap analysis is needed to define the extent of the mismatch between the demand for specialists by health care systems and educational institutions versus the capacity to train clinical pharmacists at the specialty level.

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Emergency Pharmacist Impact on Health Care-Associated Pneumonia Empiric Therapy

Abstract: The presence of the EPh significantly increased the likelihood of at-risk patients receiving empiric antimicrobial therapy consistent with guideline recommendations.

Cited by 24 publications

References 21 publications

Implications of the presence of an emergency medicine pharmacist during critical care trauma patient resuscitation

Implications of the presence of an emergency medicine pharmacist during critical care trauma patient resuscitation

Standard of practice in emergency medicine for pharmacy services

The Need forPGY2‐Trained Clinical Pharmacy Specialists

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