Use of an electronic medical record system to improve antimicrobial stewardship

Allan, Peter; Newman, Michael; Collinson, J; Bond, Lindsay; English, Will

doi:10.1186/cc14189

Cited by 1 publication

(4 citation statements)

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“…Most evidence came from specialty settings (such as intensive care, emergency medicine and paediatrics); and from high‐risk patient groups (e.g. those at risk for or with infections); and from tertiary care …”

Section: Resultsmentioning

confidence: 99%

“…We found that most work has been conducted in relation to CPOE and CDS systems, focusing on interventions that targeted individual prescribers through prompts and reminders …”

Section: Resultsmentioning

confidence: 99%

“…The majority of systems were “home‐grown” standalone systems, implemented in single centres and extensively customised; but we also identified some work on packaged applications . Research activity surrounding more complex and distributed functionalities that integrated ePrescribing with medical notes, pharmacy systems and laboratory results was less common …”

Section: Resultsmentioning

confidence: 99%

“…In relation to practitioner performance, the studies reported improved turnaround time for first dose of antibiotic, improved selection of antibiotics (e.g. in line with local protocols), optimal dosing, improved adherence to guidelines/protocols, and a decrease in the total number of antibiotics prescribed . Some studies also reported a reduction in prescribing errors and increased de‐escalation, as well as improved antibiotic sensitivity and increase in sensitivity of surgical site infection detection .…”

Section: Resultsmentioning

confidence: 99%

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Approaches to promoting the appropriate use of antibiotics through hospital electronic prescribing systems: a scoping review

et al. 2016

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Objective To identify approaches of using stand-alone and more integrated hospital ePrescribing systems to promote and support the appropriate use of antibiotics, and identify gaps in order to inform future efforts in this area. Methods A systematic scoping review of the empirical literature from 1997 until 2015, searching the following databases: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Google Scholar, Clinical Trials, International Standard Randomised Controlled Trial Number Registry, Economic Evaluation database and International Prospective Register of Systematic Reviews. Search terms related to different components of systems, hospital settings and antimicrobial stewardship. Two reviewers independently screened papers and mutually agreed papers for inclusion. We undertook an interpretive synthesis. Key findings We identified 143 papers. The majority of these were single-centre observational studies from North American settings with a wide range of system functionalities. Most evidence related to computerised decision support (CDS) and computerised physician order entry (CPOE) functionalities, of which many were extensively customised. We also found some limited work surrounding integration with laboratory results, pharmacy systems and organisational surveillance. Outcomes examined included healthcare professional performance, patient outcomes and health economic evaluations. We found at times conflicting conclusions surrounding effectiveness, which may be due to heterogeneity of populations, technologies and outcomes studied. Reports of unintended consequences were limited. Conclusions Interventions are centred on CPOE and CDS, but also include additional functionality aiming to support various facets of the medicines management process. Wider organisational dimensions appear important to supporting adoption. Evaluations should consider processes, clinical, economic and safety outcomes in order to generate generalisable insights into safety, effectiveness and cost-effectiveness.

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Section: Resultsmentioning

confidence: 99%

“…We found that most work has been conducted in relation to CPOE and CDS systems, focusing on interventions that targeted individual prescribers through prompts and reminders …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%