Impact of the Integration of a Vancomycin Review Process into the Pharmacokinetic (PK) Consultation Process
Project Description: CMS/TJC requirements for antimicrobial sterwardship practice includes ongoing prospective review of antibiotics' need. To comply with these requirements, in 2017 the anti-infective subcommittee (AIS) proposed a systematic process for reviewing vancomycin at 72 hours of starting therapy while providing pharmacokinetic services. This process was approved by the pharmacy and Therapeutics (P&T) committee in May 2017 with provision that analysis of this process will be conducted at 3 months post implementation and preliminary data will be presented back to P&T. Current Process Step 1. Physician orders PK consult into EMR Step 2. Pharmacist process order (order vancomycin dose, levels and leave a progress note in the EMR) Step 3. Pharmacist continue to dose and monitor vancomycin until order is discontinued by physician New process Step 1. Physician orders PK consult into EMR Step 2. Pharmacist process order (order vancomycin dose, levels and leave a progress note in the EMR) Step 3. Pharmacist assess need to continue vancomycin at 72 hours of starting therapy. If diagnostic and clinical data do not support continuation of vancomycin, the pharmacist will take the following action: a. Contact the prescriber to discuss criteria for vancomycin use b. Suggest discontinuation of therapy, alternate therapy, or Infectious Diseases consult c. Notify the prescriber that Pharmacy will leave final dosing and monitoring recommendations and will sign off as consulting. d. Discontinue the order for the consult per protocol.
QPI: Kayihura, Manigaba, (firstname.lastname@example.org)
Advisors: (email@example.com); (firstname.lastname@example.org); Veena, Venugopalan, (email@example.com)
UF Health Big Aims: Increase Value None
MeSH Keywords: Vancomycin, Antimicrobial Protocol