Reducing Turn-Around Time for First-Dose Antibiotics



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Background: The 2012 update of the Surviving Sepsis Campaign’s Guidelines for Management of Severe Sepsis and Septic Shock recommends administration of effective antibiotics within the first hour of disease recognition; however literature describing an effective approach to expedite antibiotic administration is sparse.
Objective: To determine the effectiveness of a multidisciplinary intervention on reducing antibiotic turnaround time. Methods: A three-arm cohort design was used to assess the impact of the intervention on antibiotic turnaround time. The study consisted of a historical Control taking place in April 2013, Cohort 1 in March 2014 evaluating changes in workflow, and Cohort 2 in April 2014 evaluating activation of a medical logic module (MLM). Results: Workflow revisions reduced turnaround time for stat orders on acute care units by decreasing the percent of orders delayed greater than 4 hours (19.6 vs. 8.4%, p = 0.009), but did not have any effect on any other subpopulation. Activation of the MLM resulted in a 54% decrease in mean turnaround time Cohort 2. Conclusion: The combined effect of the workflow revisions and activation of MLM improved mean antibiotic turnaround time and the percent of first-doses administered within 60 minutes.



Antibiotics, Sepsis, Septic shock, Medical logic module, Clinical decision support, MLM, CDS, Pharmacy