Evaluation of Emergency Medicine Pharmacist Impact on Blood Culture Review Following Emergency Department Discharge

Conditions

• Bacteremia

Eligibility Criteria

Sex

ALL

Age

18 Years - N/A

Healthy Volunteers

Accepted

Interventions

• No Intervention — OTHER
  No Intervention

Study Details

Patients are commonly discharged from the Emergency Department(ED) with pending blood culture results. Blood cultures can take up to 48 hours to become positive which is why it is important to notify patients with true positive cultures as soon as possible. Delay in notification can lead to other serious complications such as sepsis, septic shock, and death. The American College of Emergency Physicians states pharmacists serve a critical role in ensuring efficient, safe, and effective medication use in the ED and advocates for health systems to support dedicated roles for pharmacists within the ED. Pharmacists help to decrease the workload on the healthcare team, especially in the ED where there is high volume and acuity.Emergency medicine pharmacist (EMP) play a significant role in the optimization of therapy, medication safety, and reducing costs. There is strong evidence for the positive impact EMPs have on microbiological culture review. Overall, pharmacist review of late cultures results in higher rates of appropriate antimicrobial therapy and decreased missed interventions.These prior studies focused on the review of microbiological tests, including sexually transmitted infections, urine, and wound cultures; however, there was limited data to support the role of pharmacists evaluating late blood culture results.

Key Dates

Start date

Jan 31, 2024

Status verified

Jan 2026

Primary completion

Jan 31, 2027

Completion

Jan 31, 2028

Study Design

Enrollment

126 participants (estimated)

Arms

• Arm: Emergency medicine pharmacist (EMPs)
  EMPs, utilizing a Collaborative practice agreements(CPA), will be associated with a significantly shorter time to patient review and notification of positive blood culture compared to a CN-physician review.
• Arm: Charge nurse (CN's)
  To determine the effect of EMPs, utilizing a CPA, on the appropriateness of antibiotic selection upon return admission for bacteremia, reasons for patient return to hospital (i.e., return due to call - expectant, worsening of symptoms - non-expectant, other) compared to the standard CN-physician facilitated process, and rates of inappropriate call backs for reassessment or admissions (i.e., contaminant call backs).

Primary Outcome Measure

Time from an actionable positive blood culture to the time of review and/or patient notification. ult. [ Time Frame: 18 months ]

Central Contacts

• Crystee Cooper, DHEd
  214-947-1280
  [email protected]

Locations (1)

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