Faster Process to Find Cause of Blood Infections Shortens Patient Stays
A new protocol to treat patients with blood infections enabled Einstein Medical Center Montgomery to avoid $300,000 in costs over a four-month period by shortening patient stays. The protocol expedites the identification of the bacterium that’s causing the infection and enlists the pharmacist to identify and communicate the appropriate antibiotic to the treatment team.
Patients hospitalized with severe infections are immediately started on broad-spectrum antibiotics which target a wide range of bacteria because it is not immediately known what is causing the infection. The microbiology lab implemented a new testing method which can identify the offending bacteria up to a day sooner.
A new procedure was created alongside the testing method in which the laboratory would contact both the nurse and pharmacist with lab results; the pharmacist then uses an algorithm to determine the most appropriate antibiotic and directly provides the information to the physician.
“The protocol reduced patient stay by nearly a day and a half, which reduced the potential costs of patient care by $322,508, according to our research,” said David Ezdon, an infectious diseases clinical pharmacist at Einstein Montgomery.
That amount was determined by evaluating patient stays during the four months prior to the implementation of the new procedure and the four months after – 99 patients prior and 103 patients afterwards. The new process resulted in patients being switched to a targeted antibiotic more than a day sooner than before.
“Our goal is to streamline antibiotic usage throughout the hospital and decrease antibiotic resistance,” said Ezdon, who heads the antimicrobial stewardship program at Einstein Montgomery. Broad-spectrum antibiotic use can contribute to antibiotic resistance, so switching to an antibiotic specifically targeted to a patient’s infection as soon as possible is the optimal approach.
The rapid-fire communications between the lab, the pharmacist and the doctor is enabled by the fact that the lab and the pharmacist are staffed around the clock, Ezdon said. Other hospitals may only do the tests once a day and communicate the results in reports with other lab results, potentially delaying the response time.
The research was recently presented at a conference of the Association for Professionals in Infection Control and Epidemiology (APIC) in Philadelphia.