Addressing Inpatient Beta-Lactam Allergies: A Multihospital Implementation

被引：80

作者：

Blumenthal, Kimberly G. ^{[1
,2
,3
,4
,5
]}

Shenoy, Erica S. ^{[2
,5
,6
,7
]}

Wolfson, Anna R. ^{[1
,5
]}

Berkowitz, David N. ^{[8
]}

Carballo, Victoria A. ^{[9
]}

Balekian, Diana S. ^{[10
,11
]}

Marquis, Kathleen A. ^{[12
,13
]}

Elshaboury, Ramy ^{[14
]}

Gandhi, Ronak G. ^{[14
]}

Meka, Praveen ^{[5
,15
]}

Kubiak, David W. ^{[5
,12
,16
]}

Catella, Jennifer ^{[17
]}

Lambl, Barbara B. ^{[18
]}

Hsu, Joyce T. ^{[5
,13
]}

Freeley, Monique M. ^{[19
]}

Gruszecki, Alana ^{[20
]}

Wickner, Paige G. ^{[5
,13
]}

机构：

[1] Massachusetts Gen Hosp, Dept Med, Div Rheumatol Allergy & Immunol, Boston, MA 02114 USA

[2] Massachusetts Gen Hosp, Med Practice Evaluat Ctr, Boston, MA 02114 USA

[3] Massachusetts Gen Hosp, Edward P Lawrence Ctr Qual & Safety, Boston, MA 02114 USA

[4] Massachusetts Gen Profess Org, Boston, MA USA

[5] Harvard Med Sch, Boston, MA USA

[6] Massachusetts Gen Hosp, Infect Control Unit, Boston, MA 02114 USA

[7] Massachusetts Gen Hosp, Dept Med, Div Infect Dis, Boston, MA 02114 USA

[8] Newton Wellesley Hosp, Dept Pharm, Newton, MA USA

[9] Partners HealthCare Qual Safety & Value, Boston, MA USA

[10] North Shore Med Ctr, Allergy Unit, Dept Med, Salem, MA USA

[11] Asthma & Allergy Affiliates, Salem, MA USA

[12] Brigham & Womens Hosp, Div Rheumatol, 75 Francis St, Boston, MA 02115 USA

[13] Brigham & Womens Hosp, Dept Med, Div Rheumatol Allergy & Immunol, 75 Francis St, Boston, MA 02115 USA

[14] Massachusetts Gen Hosp, Dept Pharm, Boston, MA 02114 USA

[15] Brigham & Womens Faulkner Hosp, Dept Med, Boston, MA USA

[16] Brigham & Womens Hosp, Dept Med, Div Infect Dis, 75 Francis St, Boston, MA 02115 USA

[17] Partners HealthCare Syst, Partners eCare, Boston, MA USA

[18] North Shore Med Ctr, Div Infect Dis, Dept Med, Salem, MA USA

[19] North Shore Med Ctr, Pharm Dept, Salem, MA USA

[20] Brigham & Womens Faulkner Hosp, Pharm Dept, Boston, MA USA

来源：

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE | 2017年 / 5卷 / 03期

基金：

美国国家卫生研究院;

关键词：

Policy; Guideline; Stewardship; Adverse drug reaction; Hypersensitivity; Allergy; Beta-lactam; Drug; Penicillin; Test dose; Graded challenges; Quality improvement; STEWARDSHIP PROGRAM GUIDELINES; INFECTIOUS-DISEASES SOCIETY; ELECTRONIC HEALTH RECORDS; ADVERSE DRUG EVENTS; PENICILLIN ALLERGY; HOSPITALIZED-PATIENTS; ANTIMICROBIAL STEWARDSHIP; REPORTING PENICILLIN; ANTIBIOTIC SELECTION; CARE EPIDEMIOLOGY;

D O I：

10.1016/j.jaip.2017.02.019

中图分类号：

R392 [医学免疫学];

学科分类号：

100102 ;

摘要：

Addressing inaccurate penicillin allergies is encouraged as part of antibiotic stewardship in the inpatient setting. However, implementing interventions targeted at the 10% to 15% of inpatients reporting a previous penicillin allergy can pose substantial logistic challenges. We implemented a computerized guideline for patients with reported beta-lactam allergy at 5 hospitals within a single health care system in the Boston area. In this article, we describe our implementation roadmap, including both successes achieved and challenges faced. We explain key implementation steps, including assembling a team, stakeholder engagement, developing or selecting an approach, spreading the change, establishing measures, and measuring impact. The objective was to detail the lessons learned while empowering others to be part of this important, multidisciplinary work to improve the care of patients with reported beta-lactam allergies. (C) 2017 American Academy of Allergy, Asthma & Immunology

引用

页码：616 / +

页数：17

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