Utilization and Impact of Pharmacist-led, Urinary Culture Follow-Up After Discharge from the Emergency Department
Introduction: Urinary tract infections (UTI) are a common reason for an emergency department (ED) visit. The majority of these patients are discharged directly home without a hospital admission. After discharge, emergency physicians have traditionally managed the care of the patient if a change is w...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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eScholarship Publishing, University of California
2023-05-01
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| Series: | Western Journal of Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/1tw0202r |
| _version_ | 1797798209434681344 |
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| author | Danny Pham Stephen Lee Sadaf Abrishami Bharath Chakravarthy Soheil Saadat |
| author_facet | Danny Pham Stephen Lee Sadaf Abrishami Bharath Chakravarthy Soheil Saadat |
| author_sort | Danny Pham |
| collection | DOAJ |
| description | Introduction: Urinary tract infections (UTI) are a common reason for an emergency department (ED) visit. The majority of these patients are discharged directly home without a hospital admission. After discharge, emergency physicians have traditionally managed the care of the patient if a change is warranted (as a result of urine culture results). However, in recent years clinical pharmacists in the ED have largely incorporated this task into their standard practice. In our study, we aimed to 1) describe our unique process in having a pharmacist-led, urinary culture follow-up, and 2) compare it to our previous, more traditional process. Methods: In our retrospective study, we evaluated the impact of a pharmacist-led, urinary culture follow-up program after discharge from the ED. We included patients prior to and after the implementation of our new protocol to compare the differences. The primary outcome was time to intervention after urine culture result was released. Secondary outcomes included rate of documentation of intervention, appropriate interventions made, and repeat ED visits within 30 days. Results: We included a total of 265 unique urine cultures from 264 patients in the study: 129 cultures were from the period prior to implementation of the protocol, and 136 were from the post-implementation period. There were no significant differences between pre- and post-implementation groups for the primary outcome. Appropriate therapeutic intervention based on positive urine culture results was 16.3% in the pre-implementation group vs 14.7% in the post-implementation group (P=0.72). Secondary outcomes of time to intervention, documentation rates, and readmissions were similar between both groups. Conclusion: Implementation of a pharmacist-led, urinary culture follow-up program after discharge from the ED led to similar outcomes as a physician-run program. An ED pharmacist can successfully run a urinary culture follow-up program in an ED without physician involvement. |
| first_indexed | 2024-03-13T04:00:02Z |
| format | Article |
| id | doaj.art-7aa9fc18c4ad40c3bcd826d1a450a2a5 |
| institution | Directory Open Access Journal |
| issn | 1936-9018 |
| language | English |
| last_indexed | 2024-03-13T04:00:02Z |
| publishDate | 2023-05-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-7aa9fc18c4ad40c3bcd826d1a450a2a52023-06-21T18:00:40ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-90182023-05-0124310.5811/westjem.59116wjem-24-396Utilization and Impact of Pharmacist-led, Urinary Culture Follow-Up After Discharge from the Emergency DepartmentDanny Pham0Stephen Lee1Sadaf Abrishami2Bharath Chakravarthy3Soheil Saadat4University of California Irvine Medical Center, Department of Pharmacy, Orange, CaliforniaUniversity of California Irvine Medical Center, Department of Pharmacy, Orange, CaliforniaUniversity of California Irvine Medical Center, Department of Pharmacy, Orange, CaliforniaUniversity of California Irvine Medical Center, Department of Emergency Medicine, Orange, CaliforniaUniversity of California Irvine Medical Center, Department of Emergency Medicine, Orange, CaliforniaIntroduction: Urinary tract infections (UTI) are a common reason for an emergency department (ED) visit. The majority of these patients are discharged directly home without a hospital admission. After discharge, emergency physicians have traditionally managed the care of the patient if a change is warranted (as a result of urine culture results). However, in recent years clinical pharmacists in the ED have largely incorporated this task into their standard practice. In our study, we aimed to 1) describe our unique process in having a pharmacist-led, urinary culture follow-up, and 2) compare it to our previous, more traditional process. Methods: In our retrospective study, we evaluated the impact of a pharmacist-led, urinary culture follow-up program after discharge from the ED. We included patients prior to and after the implementation of our new protocol to compare the differences. The primary outcome was time to intervention after urine culture result was released. Secondary outcomes included rate of documentation of intervention, appropriate interventions made, and repeat ED visits within 30 days. Results: We included a total of 265 unique urine cultures from 264 patients in the study: 129 cultures were from the period prior to implementation of the protocol, and 136 were from the post-implementation period. There were no significant differences between pre- and post-implementation groups for the primary outcome. Appropriate therapeutic intervention based on positive urine culture results was 16.3% in the pre-implementation group vs 14.7% in the post-implementation group (P=0.72). Secondary outcomes of time to intervention, documentation rates, and readmissions were similar between both groups. Conclusion: Implementation of a pharmacist-led, urinary culture follow-up program after discharge from the ED led to similar outcomes as a physician-run program. An ED pharmacist can successfully run a urinary culture follow-up program in an ED without physician involvement.https://escholarship.org/uc/item/1tw0202r |
| spellingShingle | Danny Pham Stephen Lee Sadaf Abrishami Bharath Chakravarthy Soheil Saadat Utilization and Impact of Pharmacist-led, Urinary Culture Follow-Up After Discharge from the Emergency Department Western Journal of Emergency Medicine |
| title | Utilization and Impact of Pharmacist-led, Urinary Culture Follow-Up After Discharge from the Emergency Department |
| title_full | Utilization and Impact of Pharmacist-led, Urinary Culture Follow-Up After Discharge from the Emergency Department |
| title_fullStr | Utilization and Impact of Pharmacist-led, Urinary Culture Follow-Up After Discharge from the Emergency Department |
| title_full_unstemmed | Utilization and Impact of Pharmacist-led, Urinary Culture Follow-Up After Discharge from the Emergency Department |
| title_short | Utilization and Impact of Pharmacist-led, Urinary Culture Follow-Up After Discharge from the Emergency Department |
| title_sort | utilization and impact of pharmacist led urinary culture follow up after discharge from the emergency department |
| url | https://escholarship.org/uc/item/1tw0202r |
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