Penicillin Allergy Testing: An Outpatient Nurse-Driven Program for Patients With Cancer

Morjaria, Sejal; Inumerables, Faye; Patel, Dhruvkumar; Cohen, Nina; Seo, Susan K.; Posthumus, Susan; Martin, Steven C.; Kaltsas, Anna; Lee, Shawna; Boucher, Nathalie; Fischer-Cartlidge, Erica

doi:10.1188/21.cjon.143-150

Cited by 6 publications

(4 citation statements)

References 16 publications

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“…Incorporating a validated, reproducible tool such as the Austin Health tool in the routine evaluation and potential removal of allergy labels could be associated with benefits for patients (reduced morbidity and mortality), for the hospital (reduced cost and duration of inpatient stays) and for wider society (by avoidance of unnecessarily broad-spectrum antibiotic use). [13][14][15][16]19 Together, these findings support the introduction of a service to undertake routine evaluation of beta-lactam allergy labels at North Shore Hospital. The training of front-line staff who undertake the initial medication history and medication reconciliation (medical, surgical, and pharmacy staff) in the routine use of an AAAT would be beneficial in terms of antibiotic stewardship and patient outcomes.…”

Section: Clinical Manifestations Number (%) Of Patients (N=27)mentioning

confidence: 57%

“…12 This study echoes the growing body of international evidence that similarly supports the removal of antibiotic allergy labels by both non-specialist and allergy-specialised services using verified antibiotic assessment tools. [13][14][15][16] An adverse drug reaction encompasses all adverse events related to a medication and its administration, while an allergy is restricted specifically to an IgE-mediated reaction. We wanted to identify the accuracy of documented antibiotic allergies and ADRs in inpatients at our institute, and to assess the potential impact of an antibiotic allergy evaluation service on antibiotic allergy labels.…”

mentioning

confidence: 99%

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Description and accuracy of antibiotic allergy labels at North Shore Hospital

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Kelly,

Cutfield

2023

NZMJ

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aims: Antibiotic allergy labels are common and associated with adverse care. Most people with an antibiotic allergy label are found to be non-allergic on investigation. The aims of this study were to evaluate the burden and accuracy of antibiotic allergy labels at North Shore Hospital and to identify and assess beta-lactam specific allergies, and the potential impact of an inpatient antibiotic allergy service.methods: An evaluation of documented inpatient adverse drug reaction (ADR) labels. Structured assessment of beta-lactam allergies was undertaken using the Austin Health tool.results: Three hundred and seven patients were reviewed; 78 patients had an antibiotic allergy label, with 102 individual labels.Fifty-five of these 78 patients underwent structured assessment. Forty-four patients had a beta-lactam-specific antibiotic allergy label.Using the Austin Health tool, 9/44 (20%) of beta-lactam-specific allergy labels could have been removed following a history alone and a further 16/44 (36%) would have been appropriate for direct oral challenge. Antibiotic allergy label accuracy was 64% for beta-lactam antibiotics, and 69% for non-beta-lactams. conclusions:The prevalence of antibiotic specific allergies in our centre was similar to New Zealand and Australian statistics. 1,2 Our study showed that a significant proportion of inpatients with a beta-lactam-specific allergy could be de-labelled on history or with a single dose challenge.

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Section: Clinical Manifestations Number (%) Of Patients (N=27)mentioning

confidence: 57%

mentioning

confidence: 99%

Description and accuracy of antibiotic allergy labels at North Shore Hospital

Read,

Kelly,

Cutfield

2023

NZMJ

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“…In addition, CNSs lead several programs and initiatives such as the organization's Penicillin Allergy Testing (PAT) program, which is an outpatient nurse-driven program for patients with cancer. 9 Clinical nurse specialists are well-prepared to lead and oversee outpatient programs, such as PAT program, given their advanced practice knowledge, clinical skills, and systems perspective. For the PAT program, where allergy testing for oncology patients has complex underpinnings, CNS integrate clinical expertise, direct patient care delivery, and staff education and training for seamless achievement of the program goals according to established policy.…”

Section: Committee Involvementmentioning

confidence: 99%

“…Clinical nurse specialists bring clinical expertise to the discussions by highlighting practice concerns, offering recommendations, and sharing insight from frontline staff and interprofessional teams. In addition, CNSs lead several programs and initiatives such as the organization's Penicillin Allergy Testing (PAT) program, which is an outpatient nurse-driven program for patients with cancer 9 . Clinical nurse specialists are well-prepared to lead and oversee outpatient programs, such as PAT program, given their advanced practice knowledge, clinical skills, and systems perspective.…”

Section: Systems/organization Spherementioning

confidence: 99%

Oncology Clinical Nurse Specialists Practice in the Outpatient Setting

Inumerables,

Freedman,

Leary

et al. 2024

Clin Nurse Spec

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Purpose/Objectives With rapidly evolving oncology care, the role of the outpatient clinical nurse specialist is most valuable and essential. The purpose of this article is to describe the role of the clinical nurse specialist in the ambulatory oncology settings and highlight the clinical nurse specialists' unique influence across the spheres of impact. Description of the Project/Program This article shares several contributions of an outpatient clinical nurse specialist, which include ways this role impacts nursing practice, patient care, and standardizing organizational guidelines. A method of recording the clinical nurse specialists' encounters or indirect consults was also utilized to provide a process to log consultation received in the day-to-day practice. Work exemplars were included to further demonstrate the impact of this role in this setting. Conclusion Outpatient clinical nurse specialist need is rising especially in the oncology setting where the majority of cancer care and treatment is delivered. It is important to continue to disseminate and highlight the value it brings to the organization.

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Implementation and outcomes of beta-lactam allergy management protocol at a comprehensive cancer center

So,

Khalak,

et al. 2024

Infection

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Penicillin Allergy Testing: An Outpatient Nurse-Driven Program for Patients With Cancer

Cited by 6 publications

References 16 publications

Description and accuracy of antibiotic allergy labels at North Shore Hospital

Description and accuracy of antibiotic allergy labels at North Shore Hospital

Oncology Clinical Nurse Specialists Practice in the Outpatient Setting

Implementation and outcomes of beta-lactam allergy management protocol at a comprehensive cancer center

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