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Antimicrobial Consumption Data From Pharmacy and Nursing Records: How Good Are They?

Published online by Cambridge University Press:  21 June 2016

Gail S. Itokazu ,
Robert C. Glowacki ,
David N. Schwartz ,
Mary F. Wisniewski ,
Robert J. Rydman  and
Robert A. Weinstein
Gail S. Itokazu*
Affiliation:
John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois University of Illinois at Chicago College of Pharmacy, Chicago, Illinois
Robert C. Glowacki
Affiliation:
John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois University of Illinois at Chicago College of Pharmacy, Chicago, Illinois
David N. Schwartz
Affiliation:
John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois Rush Medical College, Chicago, Illinois
Mary F. Wisniewski
Affiliation:
John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois
Robert J. Rydman
Affiliation:
John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois University of Illinois at Chicago School of Public Health, Chicago, Illinois
Robert A. Weinstein
Affiliation:
John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois Rush Medical College, Chicago, Illinois
*
John H. Stroger Jr. Hospital of Cook County, Division of Infectious Diseases, 637 S. Wood St., Durand Building – Room 110, Chicago, IL 60612[email protected]
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Abstract

Objective:

To determine whether randomly selected intravenous (IV) antimicrobial doses dispensed from an inpatient pharmacy were administered.

Design:

This was a prospective, cross-sectional study in which dose administration was confirmed by direct observation and by assessment of the medication administration record (MAR). A retrospective analysis of the return rate of unused IV antimicrobial doses was performed subsequently.

Setting:

Medical and surgical intensive care units (ICUs) and non-ICUs of a 550-bed urban public teaching hospital.

Participants:

Hospitalized patients with an order in the pharmacy database for an IV antimicrobial during 9 non-consecutive weekdays in June 1999.

Results:

Of 397 doses, 221 (55.7%) assessed by bedside observation and 238 (59.9%) assessed by MAR review were classified as administered; 139 doses (35.0%) were dispensed but changes in the drug order or the patient's status prevented their administration. In the subsequent assessment, of 745 IV antimicrobial doses dispensed during 24 hours, 322 (43.2%) were returned to the pharmacy unused; 423 (56.8%) of the doses—consistent with our prior observations—were presumably administered.

Conclusions:

Because computerized pharmacy data may overestimate actual antimicrobial consumption, such data should be validated when used in studies of hospital antimicrobial use. Dispense-return analysis offers a simple validation method.

Type
Orginal Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 4 , April 2005 , pp. 395 - 400
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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