Articles: emergency-department.
-
Antimicrobial prescribing in the emergency department is predominantly empiric, with final microbiology results either unavailable or reported after most patients are discharged home. Systematic follow-up processes are needed to ensure appropriate antimicrobial therapy at this transition of care. The objective of this study was to assess the impact of a culture follow-up (CFU) program on the frequency of emergency department (ED) revisits within 72 h and hospital admissions within 30 days compared to the historical standard of care (SOC). Additionally, infection characteristics and antimicrobial therapy were compared. ⋯ Implementation of a multidisciplinary CFU program was associated with a reduction in ED revisits within 72 h and hospital admissions within 30 days. One-fourth of patients required post-discharge intervention, representing a large need for antimicrobial stewardship expansion to ED practice models.
-
J Pediatric Infect Dis Soc · Jun 2014
A National Study of the Impact of Rapid Influenza Testing on Clinical Care in the Emergency Department.
Rapid influenza diagnostic tests (RIDT) may influence physician decision-making. Single-center studies suggest that influenza diagnosed in association with RIDT reduces ancillary testing and antibiotic prescribing. The extent of RIDT use in US emergency departments (EDs) and their impact on patient management are unknown. We examined the use of RIDT and its effect on influenza management, using a national sample of ED visits. ⋯ Influenza diagnoses made in association with RIDT resulted in fewer tests and antibiotic prescriptions and more frequent use of antivirals. This finding suggests that test results influence physician behavior.
-
Observational Study
Adverse Drug Event Nonrecognition in Emergency Departments: An Exploratory Study on Factors Related to Patients and Drugs.
Many adverse drug events (ADEs) are not identified by emergency physicians. Research has been done to study risk factors for ADEs and help emergency physicians diagnose ADEs. However, no research has specifically examined the causes underlying a lack of attribution of ADEs to medications in emergency department (ED) patients. ⋯ Our results emphasize the importance of searching for ADEs in patients with daily polypharmacy or whose chief complaint does not seem to be drug related.