Evaluation of Emergency Medicine Pharmacist Impact on Blood Culture Review Following Emergency Department Discharge
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.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Crystee Cooper, DHEd
- Phone Number: 214-947-1280
- Email: ClinicalResearch@mhd.com
Study Locations
-
-
Texas
-
Dallas, Texas, United States, 75203
- Recruiting
- Clinical Research Institute Methodist Health System
-
Contact:
- Crystee Cooper, DHEd
- Phone Number: 214-941-1285
- Email: CrysteeCooper@mhd.com
-
Contact:
- Email: clinicalresearch@mhd.com
-
Principal Investigator:
- Kevin Burnham, PharmD
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Patients with a positive blood culture result, collected during the initial ED visit and who were discharged from the ED to the outpatient/long-term care setting prior to a critical blood Groups culture result.
Exclusion Criteria:
- Patients admitted to inpatient and patients transferred from ED to another acute care facility.
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
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.
|
No Intervention
|
|
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).
|
No Intervention
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Time from an actionable positive blood culture to the time of review and/or patient notification. ult.
Time Frame: 18 months
|
Time to patient notification is defined as time until the first attempt to contact the patient regarding the actionable positive res
|
18 months
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Andrew Karpisek, MD, Methodist Health System
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 057.PHA.2023.A
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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