The Journal of Informed Pharmacotherapy 2004;15:409.
Vicki Wong, B.Sc.(Pharm), Zahra Kanji, B.Sc.(Pharm),PharmD, Rajesh Mainra MD,
FRCPC, FCCP, Michael Boldt, MD, FRCPC
Department of Pharmacy, Lions Gate Hospital, North Shore Health Region, North Vancouver; Department of Pharmacy and Critical Care, Lions Gate Hospital, North Shore Health Region, North Vancouver, and Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver; Department of Respirology, Lions Gate Hospital, North Shore Health Region, North Vancouver; Department of Internal Medicine, Lions Gate Hospital, North Shore Health Region, and North Vancouver, British Columbia
Canadian Society of Hospital Pharmacists (British Columbia Branch) Residency Research Presentation Night, Vancouver, British Columbia, Canada. May 2003.
A preprinted order (PPO) was implemented to improve the management of Community-Acquired Pneumonia (CAP). The study objective was to evaluate usage of the PPO and characterize management of CAP after PPO implementation.
A Canadian community adult acute care hospital.
A retrospective chart review of patients admitted with CAP in 2002: Group A (PPO), Group B (no PPO), and control group (2000 study).
Of the 105 patients included, 42% had the PPO in their charts. Both Group A and B had a mean LOS of 7 days. Of Group A patients with and without Pneumonia Severity Index (PSI) scores, Group B patients and control group patients, 8%, 36%, 37%, and 16% respectively were inappropriately admitted. Guideline recommended cultures were performed in 63%, 25% and 47% of Group A, Group B and control group patients and usage of empirical antibiotics were consistent with the guidelines in 74%, 65% and 53% respectively. Of eligible Group A, Group B and control group patients, 67%, 65% and 64% respectively received step-down (SD) with group averages of 3.1, 5.4 and 2.5 days to SD. Of eligible Group A and Group B patients, 57% and 61% respectively had timely discharge with an average of 3.4 and 2.7 days to discharge.
After PPO implementation, inappropriate hospitalization decreased, while rates of cultures and empiric antibiotics usage consistent with the guidelines increased. LOS did not decrease and occurrence and timeliness of SD or ED did not increase.
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