A Successful Pharmacist-Based Quality Initiative to Reduce Inappropriate Stress Ulcer Prophylaxis Use in an Academic Medical Intensive Care Unit
Stress ulcer prophylaxis (SUP) is often inappropriately utilized, particularly in critically ill patients. The objective of this study is to find an effective way of reducing inappropriate SUP use in an academic medical intensive care unit (ICU). Medical ICU patients receiving SUP were identified ov...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2018-03-01
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| Series: | Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| Online Access: | https://doi.org/10.1177/0046958018759116 |
| _version_ | 1819056295243677696 |
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| author | Umair Masood MD Anuj Sharma MD Zabeer Bhatti MD Jessica Carroll BSc Amit Bhardwaj MD Devamohan Sivalingam MD Amit S. Dhamoon MD, PhD |
| author_facet | Umair Masood MD Anuj Sharma MD Zabeer Bhatti MD Jessica Carroll BSc Amit Bhardwaj MD Devamohan Sivalingam MD Amit S. Dhamoon MD, PhD |
| author_sort | Umair Masood MD |
| collection | DOAJ |
| description | Stress ulcer prophylaxis (SUP) is often inappropriately utilized, particularly in critically ill patients. The objective of this study is to find an effective way of reducing inappropriate SUP use in an academic medical intensive care unit (ICU). Medical ICU patients receiving SUP were identified over a 1-month period, and their charts were reviewed to determine whether American Society of Health-System Pharmacists guidelines were followed. Inappropriate usage was calculated as inappropriate patient-days and converted to incidence per 100 patient-days. Two interventions were implemented: (1) Pharmacists reviewed indications for SUP on each patient during daily team rounds and daily medication reconciliation and (2) residents rotating on ICU services were educated on a bimonthly basis. Postintervention data were obtained in a similar fashion. Prior to intervention, the incidence of inappropriate SUP usage was calculated to be 26.75 per 100 patient-days (n = 1099 total patient-days). Total cost attributable to the inappropriate use was $2433. Post intervention, we were able to decrease the inappropriate incidence of SUP usage to 7.14 per 100 patient-days (n = 1149 total patient-days). In addition, total cost of inappropriate use was reduced to $239.80. Our study highlights an effective multidisciplinary approach to reduce the inappropriate use of SUP in an academic medical ICU. We were able to reduce the incidence of inappropriate use of SUP by 73.31% ( P < .001). Furthermore, we were able to decrease the costs by approximately $2200/month. |
| first_indexed | 2024-12-21T13:21:08Z |
| format | Article |
| id | doaj.art-288e0b549e1c42a681df2d0fd872ec5f |
| institution | Directory Open Access Journal |
| issn | 0046-9580 1945-7243 |
| language | English |
| last_indexed | 2024-12-21T13:21:08Z |
| publishDate | 2018-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| spelling | doaj.art-288e0b549e1c42a681df2d0fd872ec5f2022-12-21T19:02:35ZengSAGE PublishingInquiry: The Journal of Health Care Organization, Provision, and Financing0046-95801945-72432018-03-015510.1177/0046958018759116A Successful Pharmacist-Based Quality Initiative to Reduce Inappropriate Stress Ulcer Prophylaxis Use in an Academic Medical Intensive Care UnitUmair Masood MD0Anuj Sharma MD1Zabeer Bhatti MD2Jessica Carroll BSc3Amit Bhardwaj MD4Devamohan Sivalingam MD5Amit S. Dhamoon MD, PhD6State University of New York Upstate Medical University, Syracuse, NY, USAState University of New York Upstate Medical University, Syracuse, NY, USAState University of New York Upstate Medical University, Syracuse, NY, USAState University of New York Upstate Medical University, Syracuse, NY, USAState University of New York Upstate Medical University, Syracuse, NY, USAState University of New York Upstate Medical University, Syracuse, NY, USAState University of New York Upstate Medical University, Syracuse, NY, USAStress ulcer prophylaxis (SUP) is often inappropriately utilized, particularly in critically ill patients. The objective of this study is to find an effective way of reducing inappropriate SUP use in an academic medical intensive care unit (ICU). Medical ICU patients receiving SUP were identified over a 1-month period, and their charts were reviewed to determine whether American Society of Health-System Pharmacists guidelines were followed. Inappropriate usage was calculated as inappropriate patient-days and converted to incidence per 100 patient-days. Two interventions were implemented: (1) Pharmacists reviewed indications for SUP on each patient during daily team rounds and daily medication reconciliation and (2) residents rotating on ICU services were educated on a bimonthly basis. Postintervention data were obtained in a similar fashion. Prior to intervention, the incidence of inappropriate SUP usage was calculated to be 26.75 per 100 patient-days (n = 1099 total patient-days). Total cost attributable to the inappropriate use was $2433. Post intervention, we were able to decrease the inappropriate incidence of SUP usage to 7.14 per 100 patient-days (n = 1149 total patient-days). In addition, total cost of inappropriate use was reduced to $239.80. Our study highlights an effective multidisciplinary approach to reduce the inappropriate use of SUP in an academic medical ICU. We were able to reduce the incidence of inappropriate use of SUP by 73.31% ( P < .001). Furthermore, we were able to decrease the costs by approximately $2200/month.https://doi.org/10.1177/0046958018759116 |
| spellingShingle | Umair Masood MD Anuj Sharma MD Zabeer Bhatti MD Jessica Carroll BSc Amit Bhardwaj MD Devamohan Sivalingam MD Amit S. Dhamoon MD, PhD A Successful Pharmacist-Based Quality Initiative to Reduce Inappropriate Stress Ulcer Prophylaxis Use in an Academic Medical Intensive Care Unit Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| title | A Successful Pharmacist-Based Quality Initiative to Reduce Inappropriate Stress Ulcer Prophylaxis Use in an Academic Medical Intensive Care Unit |
| title_full | A Successful Pharmacist-Based Quality Initiative to Reduce Inappropriate Stress Ulcer Prophylaxis Use in an Academic Medical Intensive Care Unit |
| title_fullStr | A Successful Pharmacist-Based Quality Initiative to Reduce Inappropriate Stress Ulcer Prophylaxis Use in an Academic Medical Intensive Care Unit |
| title_full_unstemmed | A Successful Pharmacist-Based Quality Initiative to Reduce Inappropriate Stress Ulcer Prophylaxis Use in an Academic Medical Intensive Care Unit |
| title_short | A Successful Pharmacist-Based Quality Initiative to Reduce Inappropriate Stress Ulcer Prophylaxis Use in an Academic Medical Intensive Care Unit |
| title_sort | successful pharmacist based quality initiative to reduce inappropriate stress ulcer prophylaxis use in an academic medical intensive care unit |
| url | https://doi.org/10.1177/0046958018759116 |
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