Purpose: To determine whether the implementation of a pharmacist-run, real-time electronic health record (EHR) antimicrobial report reduces the frequency of delays in subsequent antibiotic medication administration timing in patients in the emergency department (ED).
Methods: A single-center, retrospective, pre-and-post quasi-experimental study was conducted between July and December 2021 following the implementation of an antimicrobial EHR report of adult patients presenting to the ED who were continued on antibiotic therapy after receiving a one-time dose of an antibiotic in the ED. The primary objective was to determine the impact of the pharmacist-run, real-time EHR antibiotic dosing report in the ED on reducing the number of major delays in subsequent antibiotic administration times. A subanalysis of the primary outcome was performed to evaluate differences in major delays based on specific dosing intervals of 6, 8, and 12 hours.
Results: A total of 521 subsequent antibiotic dosing orders from 273 patient encounters were analyzed, with major delays in subsequent antibiotic dosing administration times identified in 20% of the intervention group compared to 27% of the control group (P = 0.047). Major delays were also significantly decreased in the intervention group compared to the control group for antibiotics dosed at 8-hour intervals (18% vs 32%; P = 0.026). No significant difference in delays was observed between the groups for antibiotics dosed at 6-hour intervals (18% vs 27%) or 12-hour intervals (29% vs 21%).
Conclusion: Implementing a real-time EHR antimicrobial report run by pharmacists in the ED was associated with significantly fewer major delays in subsequent antibiotic dosing following a first dose.
Keywords: antibiotic administration delays; boarding; emergency department; emergency medicine pharmacist; pharmacovigilance.
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