Impact of order set implementation on appropriate treatment of community-acquired pneumonia (CAP)
Abstract Objective: This study aimed to evaluate appropriate antimicrobial prescribing after implementing a pneumonia order set within a community teaching hospital. Design: Retrospective chart review study. Setting: 450-bed community teaching hospital. Participants: Patients who are 18 year...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2025-01-01
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| Series: | Antimicrobial Stewardship & Healthcare Epidemiology |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2732494X24004674/type/journal_article |
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| author | Han Pham Michell J. Stein Lacy J. Worden |
| author_facet | Han Pham Michell J. Stein Lacy J. Worden |
| author_sort | Han Pham |
| collection | DOAJ |
| description |
Abstract
Objective:
This study aimed to evaluate appropriate antimicrobial prescribing after implementing a pneumonia order set within a community teaching hospital.
Design:
Retrospective chart review study.
Setting:
450-bed community teaching hospital.
Participants:
Patients who are 18 years of age or older admitted for treatment of community-acquired pneumonia (CAP) between October 1, 2021, and August 1, 2023.
Methods:
This retrospective cohort study aimed to evaluate a composite endpoint of appropriate empiric antimicrobial selection, dosing, and duration in accordance with the national guidelines after the implementation of a CAP order set. Secondary outcomes included comparing hospital length of stay (LOS), readmission rates, mortality rates, and Clostridium difficile infection rates.
Results:
A total of 236 patients were included (118 patients per group). Significantly more patients in the post-implementation group received guideline-concordant therapy for CAP (5.9% vs 35.6%, P < .001). Results were heavily influenced by improvements in appropriate durations of therapy (pre: 6.8% vs post: 39.9%, P < .001). There were no significant differences observed for LOS, 30-day readmission rates, C. difficile infections within 30 days, or mortality rates between groups. The order set was utilized in 66.1% of patients included in the post-implementation group.
Conclusions:
Implementing an order set significantly improved inpatient antibiotic prescribing for CAP with no difference in clinical or safety outcomes. Antibiotic order sets will be a useful tool for antimicrobial stewardship program expansion into other common community-acquired infections.
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| format | Article |
| id | doaj-art-8459f51f65b942e786f26e9ee0901393 |
| institution | OA Journals |
| issn | 2732-494X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Antimicrobial Stewardship & Healthcare Epidemiology |
| spelling | doaj-art-8459f51f65b942e786f26e9ee09013932025-08-20T01:49:26ZengCambridge University PressAntimicrobial Stewardship & Healthcare Epidemiology2732-494X2025-01-01510.1017/ash.2024.467Impact of order set implementation on appropriate treatment of community-acquired pneumonia (CAP)Han Pham0https://orcid.org/0009-0000-7377-2296Michell J. Stein1Lacy J. Worden2https://orcid.org/0000-0003-2406-807XAscension Borgess Hospital, Kalamazoo, MI, USAAscension Borgess Hospital, Kalamazoo, MI, USAAscension Borgess Hospital, Kalamazoo, MI, USA Abstract Objective: This study aimed to evaluate appropriate antimicrobial prescribing after implementing a pneumonia order set within a community teaching hospital. Design: Retrospective chart review study. Setting: 450-bed community teaching hospital. Participants: Patients who are 18 years of age or older admitted for treatment of community-acquired pneumonia (CAP) between October 1, 2021, and August 1, 2023. Methods: This retrospective cohort study aimed to evaluate a composite endpoint of appropriate empiric antimicrobial selection, dosing, and duration in accordance with the national guidelines after the implementation of a CAP order set. Secondary outcomes included comparing hospital length of stay (LOS), readmission rates, mortality rates, and Clostridium difficile infection rates. Results: A total of 236 patients were included (118 patients per group). Significantly more patients in the post-implementation group received guideline-concordant therapy for CAP (5.9% vs 35.6%, P < .001). Results were heavily influenced by improvements in appropriate durations of therapy (pre: 6.8% vs post: 39.9%, P < .001). There were no significant differences observed for LOS, 30-day readmission rates, C. difficile infections within 30 days, or mortality rates between groups. The order set was utilized in 66.1% of patients included in the post-implementation group. Conclusions: Implementing an order set significantly improved inpatient antibiotic prescribing for CAP with no difference in clinical or safety outcomes. Antibiotic order sets will be a useful tool for antimicrobial stewardship program expansion into other common community-acquired infections. https://www.cambridge.org/core/product/identifier/S2732494X24004674/type/journal_article |
| spellingShingle | Han Pham Michell J. Stein Lacy J. Worden Impact of order set implementation on appropriate treatment of community-acquired pneumonia (CAP) Antimicrobial Stewardship & Healthcare Epidemiology |
| title | Impact of order set implementation on appropriate treatment of community-acquired pneumonia (CAP) |
| title_full | Impact of order set implementation on appropriate treatment of community-acquired pneumonia (CAP) |
| title_fullStr | Impact of order set implementation on appropriate treatment of community-acquired pneumonia (CAP) |
| title_full_unstemmed | Impact of order set implementation on appropriate treatment of community-acquired pneumonia (CAP) |
| title_short | Impact of order set implementation on appropriate treatment of community-acquired pneumonia (CAP) |
| title_sort | impact of order set implementation on appropriate treatment of community acquired pneumonia cap |
| url | https://www.cambridge.org/core/product/identifier/S2732494X24004674/type/journal_article |
| work_keys_str_mv | AT hanpham impactofordersetimplementationonappropriatetreatmentofcommunityacquiredpneumoniacap AT michelljstein impactofordersetimplementationonappropriatetreatmentofcommunityacquiredpneumoniacap AT lacyjworden impactofordersetimplementationonappropriatetreatmentofcommunityacquiredpneumoniacap |