Rapid implementation of a clinical decision-support workflow during the national blood culture bottle shortage
Summary: Background: The United States Food and Drug Administration recently announced a national blood culture (BC) bottle shortage; the exact date of restoration is still being determined. Aim: Implement a workflow to mitigate the BC bottle shortage at our hospital. Methods: We created the follow...
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| Language: | English |
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Elsevier
2024-12-01
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| Series: | Infection Prevention in Practice |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590088924000817 |
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| author | Saira Butt Amy B. Kressel Brian L. Haines Katherine Merrill Amber M. Ryan Kenneth C. Gavina Bree Weaver Michael Kays Molly Tieman Margaret Muciarelli Phillip Clapham |
| author_facet | Saira Butt Amy B. Kressel Brian L. Haines Katherine Merrill Amber M. Ryan Kenneth C. Gavina Bree Weaver Michael Kays Molly Tieman Margaret Muciarelli Phillip Clapham |
| author_sort | Saira Butt |
| collection | DOAJ |
| description | Summary: Background: The United States Food and Drug Administration recently announced a national blood culture (BC) bottle shortage; the exact date of restoration is still being determined. Aim: Implement a workflow to mitigate the BC bottle shortage at our hospital. Methods: We created the following clinical decision support workflow in electronic medical record to help mitigate BC bottle use: (a) limit to two BC in 24 hours, (b) only repeat BC if 72 hours have passed from the prior sets, (c) do not repeat BC for coagulase-negative Staphylococcus bacteremia when considered a contaminant (i.e., no implanted vascular device), (d) do not repeat BC for Streptococcus bacteremia, (e) do not repeat cultures for Gram-negative rod bacteremia unless an unknown source, immunosuppression, or clinical worsening. Findings: Post implementation, our weekly average BC bottle use decreased to 29.5%. Conclusion: Within three weeks of the BC bottle shortage announcement, we successfully deployed evidence-based BC restrictions in the electronic medical record (EMR), reducing our BC orders by 29.5%. We encourage others to consider and potentially replicate our workflow to contribute to diagnostic stewardship. |
| format | Article |
| id | doaj-art-87fa6906182e47e7b5bde0ed72384e84 |
| institution | DOAJ |
| issn | 2590-0889 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Infection Prevention in Practice |
| spelling | doaj-art-87fa6906182e47e7b5bde0ed72384e842025-08-20T02:48:51ZengElsevierInfection Prevention in Practice2590-08892024-12-016410041710.1016/j.infpip.2024.100417Rapid implementation of a clinical decision-support workflow during the national blood culture bottle shortageSaira Butt0Amy B. Kressel1Brian L. Haines2Katherine Merrill3Amber M. Ryan4Kenneth C. Gavina5Bree Weaver6Michael Kays7Molly Tieman8Margaret Muciarelli9Phillip Clapham10Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Eskenazi Health, Indianapolis, IN, USA; Corresponding author. Address: 1120 W Michigan Rd, Indianapolis, IN, 46202, USA. Tel.: +1 601 668 9800.Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Eskenazi Health, Indianapolis, IN, USAEskenazi Health, Indianapolis, IN, USAEskenazi Health, Indianapolis, IN, USAEskenazi Health, Indianapolis, IN, USA; Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USAEskenazi Health, Indianapolis, IN, USA; Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USADepartment of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Eskenazi Health, Indianapolis, IN, USAEskenazi Health, Indianapolis, IN, USA; Department of Pharmacy, Eskenazi Health, Indianapolis, IN, USAEskenazi Health, Indianapolis, IN, USA; Department of Pharmacy, Eskenazi Health, Indianapolis, IN, USAEskenazi Health, Indianapolis, IN, USADepartment of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Eskenazi Health, Indianapolis, IN, USASummary: Background: The United States Food and Drug Administration recently announced a national blood culture (BC) bottle shortage; the exact date of restoration is still being determined. Aim: Implement a workflow to mitigate the BC bottle shortage at our hospital. Methods: We created the following clinical decision support workflow in electronic medical record to help mitigate BC bottle use: (a) limit to two BC in 24 hours, (b) only repeat BC if 72 hours have passed from the prior sets, (c) do not repeat BC for coagulase-negative Staphylococcus bacteremia when considered a contaminant (i.e., no implanted vascular device), (d) do not repeat BC for Streptococcus bacteremia, (e) do not repeat cultures for Gram-negative rod bacteremia unless an unknown source, immunosuppression, or clinical worsening. Findings: Post implementation, our weekly average BC bottle use decreased to 29.5%. Conclusion: Within three weeks of the BC bottle shortage announcement, we successfully deployed evidence-based BC restrictions in the electronic medical record (EMR), reducing our BC orders by 29.5%. We encourage others to consider and potentially replicate our workflow to contribute to diagnostic stewardship.http://www.sciencedirect.com/science/article/pii/S2590088924000817Blood cultureBottle shortageStewardshipWorkflowClinical decisionEMR tool |
| spellingShingle | Saira Butt Amy B. Kressel Brian L. Haines Katherine Merrill Amber M. Ryan Kenneth C. Gavina Bree Weaver Michael Kays Molly Tieman Margaret Muciarelli Phillip Clapham Rapid implementation of a clinical decision-support workflow during the national blood culture bottle shortage Infection Prevention in Practice Blood culture Bottle shortage Stewardship Workflow Clinical decision EMR tool |
| title | Rapid implementation of a clinical decision-support workflow during the national blood culture bottle shortage |
| title_full | Rapid implementation of a clinical decision-support workflow during the national blood culture bottle shortage |
| title_fullStr | Rapid implementation of a clinical decision-support workflow during the national blood culture bottle shortage |
| title_full_unstemmed | Rapid implementation of a clinical decision-support workflow during the national blood culture bottle shortage |
| title_short | Rapid implementation of a clinical decision-support workflow during the national blood culture bottle shortage |
| title_sort | rapid implementation of a clinical decision support workflow during the national blood culture bottle shortage |
| topic | Blood culture Bottle shortage Stewardship Workflow Clinical decision EMR tool |
| url | http://www.sciencedirect.com/science/article/pii/S2590088924000817 |
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