Implementation of antimicrobial stewardship weekend coverage within a community hospital with a PGY-2 infectious diseases pharmacy resident.

ABSTRACT

OBJECTIVES: The goal of this study was to describe the impact of expanding inpatient ASP weekend coverage with a newly established infectious diseases postgraduate second-year (ID-PGY-2) pharmacy residency program through quantification of inpatient ASP interventions. Secondary end points included comparing weekend stewardship activities before and after an ID-PGY-2 incorporated staffing model shift based on intervention quantity, type, and impact to weekends. METHODS: This retrospective cohort study was conducted evaluating weekend Antimicrobial stewardship program (ASP) interventions documented within the electronic health record between July 1, 2021, and December 31, 2022. Groups included a single clinical pharmacist, 2 new postgraduate first-year (PGY-1) pharmacy residents, 2 experienced PGY-1 pharmacy residents, and an ID-PGY-2 responsible only for ASP coverage. RESULTS: Eight weekends of interventions were collected per group. The median (interquartile range [IQR]) number of ASP interventions per weekend increased during ID-PGY-2 resident weekends (34 [28.75-35]) compared to a clinical pharmacist alone (5 [4-10], P < 0.001), and both new (2.5 [1.25-4], P < 0.001) and experienced (6 [3.5-10.5], P < 0.001) PGY-1 resident groups. The ID-PGY-2 resident initiated statistically significantly more interventions per protocol and interventions requiring communication with providers. The acceptance rate for interventions made via communication was similar between groups (ID-PGY-2 86.3% vs. clinical pharmacist 87.7% vs. new PGY-1 100% vs. experienced PGY-1 90.5%, P = 0.541). CONCLUSION: Expansion of ASP services to include weekend clinical coverage with an ID-PGY-2 pharmacy resident significantly increased weekend ASP interventions in a community teaching hospital.