EFFECT OF PHARMACIST LED WEEKEND ANTIMICROBIAL STEWARDSHIP ON VANCOMYCIN UTILIZATION Bria Benson, Julie A. Justo, Joseph Kohn, Hana Rac, P. Brandon Bookstaver Palmetto Health Richland PGY1 Pharmacy - Columbia, SC
Background/Purpose: IDSA and CDC guidelines on implementing an antimicrobial stewardship program emphasize the importance of pharmacist leadership and integration of stewardship into routine pharmacy activities. Therapeutic drug monitoring conducted by pharmacists has been shown to reduce costs and decrease adverse effects. Prior to project initiation at Prisma Health _x0013_ Midlands, pharmacists routinely completed all vancomycin pharmacokinetic dosing and monitoring for the hospital over the weekend, however, antimicrobial stewardship was not an expected duty. The purpose of this study was to expand pharmacist-driven antimicrobial stewardship services to the weekend and analyze the effects on institution wide vancomycin utilization.
Methodology: This is an IRB-approved, retrospective, observational study evaluating the effect of expanded pharmacy rounding and antimicrobial stewardship weekend service at Prisma Health _x0013_ Midlands Richland on vancomycin use. The primary endpoint is the difference in hours of vancomycin use per patient on the weekends among pre-implementation period (December 2017 to March 2018), post-implementation Phase I representing expansion of critical care rounding pharmacist on the weekends (June 2018 to August 2018), and post-implementation Phase II representing additional expansion of antimicrobial stewardship service (December 2018 to March 2019). Secondary endpoints include number of vancomycin concentrations and time to vancomycin discontinuation on the weekends. A descriptive analysis of Phase I and II will include reason for discontinuation (eg rapid diagnostic results, MRSA nasal swab, susceptibility results) and percent of interventions accepted. THERADOC® was used to collect data on number of pharmacist notes, number of attempted interventions, accepted interventions, and rejected interventions.
Presentation Objective: Understand the purpose of expanding antimicrobial stewardship service and the impact that pharmacist-driven antimicrobial stewardship can have on time to optimal therapy.
Self-Assessment: What impact does the addition of weekend expansion of a critical care rounding component and targeted stewardship expansion have on vancomycin utilization?
