Development and implementation of "handshake rounds": An antibiotic stewardship intervention for hospitalized adult patients with hematologic malignancies.
Antimicrob Steward Healthc Epidemiol
; 3(1): e76, 2023.
Article
em En
| MEDLINE
| ID: mdl-37113201
ABSTRACT
Objective:
To design and implement "handshake rounds" as an antibiotic stewardship intervention to reduce inpatient intravenous (IV) antibiotic use in patients with hematologic malignancies.Design:
Quasi-experimental analysis of antibiotic use (AU) and secondary outcomes before and and after handshake rounds were implemented.Setting:
Quaternary-care, academic medical center. Patients Hospitalized adults with hematologic malignancies receiving IV antibiotics.Methods:
We performed a retrospective review of a preintervention cohort prior to the intervention. A multidisciplinary team developed criteria for de-escalation of antibiotics, logistics of handshake rounds, and outcome metrics. Eligible patients were discussed during scheduled handshake rounds between a hematology-oncology pharmacist and transplant-infectious diseases (TID) physician. Prospective data were collected over 30 days in the postintervention cohort. Due to small sample size, 21 matching was used to compare pre- to and postintervention AU. Total AU in days of therapy per 1,000 patient days (DOT/1,000 PD) was reported. Mean AU per patient was analyzed using Wilcoxon rank-sum test. A descriptive analysis of secondary outcomes of pre- and postintervention cohorts was performed.Results:
Total AU was substantially lower after the intervention, with 517 DOT/1,000 PD compared to 865 DOT/1,000 PD before the intervention. There was no statistically significant difference in the mean AU per patient between the 2 cohorts. There was a lower rate of 30-day mortality in the postintervention cohort and rates of ICU admissions were similar.Conclusions:
Conducting handshake rounds is a safe and effective way to implement an antibiotic stewardship intervention among high-risk patient population such as those with hematologic malignancies.
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Base de dados:
MEDLINE
Idioma:
En
Revista:
Antimicrob Steward Healthc Epidemiol
Ano de publicação:
2023
Tipo de documento:
Article