Chest ACCP Education Calendar
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text Free
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (7)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Lawrence, S. J.
Right arrow Articles by Mundy, L. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lawrence, S. J.
Right arrow Articles by Mundy, L. M.
(Chest. 2002;122:913-919.)
© 2002 American College of Chest Physicians

An Intervention To Improve Antibiotic Delivery and Sputum Procurement in Patients Hospitalized With Community-Acquired Pneumonia*

Steven J. Lawrence, MD; Brooke N. Shadel, PhD, MPH; Terry L. Leet, PhD; Jonathan B. Hall, MD and Linda M. Mundy, MD

* From the Division of Infectious Diseases (Drs. Lawrence and Mundy) and Division of Emergency Medicine (Dr. Hall), Washington University School of Medicine; and Saint Louis University School of Public Health (Dr. Leet) and Center for the Study of Bioterrorism and Emerging Infections (Dr. Shadel), St. Louis, MO.

Correspondence to: Steven J. Lawrence, MD, Washington University School of Medicine, Division of Infectious Diseases, 660 South Euclid Ave, Campus Box 8051, St. Louis, MO 63110; e-mail: slawrenc{at}im.wustl.edu

Study objectives: To determine if an educational intervention targeting emergency department (ED) and medicine staff could successfully decrease the time to antibiotic delivery (door-to-drug delivery time [DDD]) for patients admitted through the ED with community-acquired pneumonia (CAP).

Design: Prospective, multidisciplinary team-based educational project. Demographics, outcomes, and processes of care including DDD and sputum procurement for patients with CAP were determined during a baseline period and compared to the same parameters for patients with CAP presenting after the educational intervention was administered to ED and medicine staff.

Setting: Barnes-Jewish Hospital, a large Midwest teaching institution affiliated with the Washington University School of Medicine.

Patients: Consecutive adult patients admitted through the ED with CAP.

Intervention: Multidisciplinary in-service education administered to ED physicians and nurses, and medicine housestaff, which emphasized the importance of rapid antibiotic delivery and procurement of preantibiotic expectorated sputum.

Results: Mean DDD improved from 413 to 291 min (p = 0.02), with more patients receiving antibiotics in the ED (46% vs 69%; adjusted odds ratio [OR], 2.3; 95% confidence interval [CI], 1.0 to 4.9). Sputum procurement improved from 11.5 to 25.4% (adjusted OR, 3.3; 95% CI, 1.1 to 9.9). There were no observed differences for inpatient mortality or length of stay.

Conclusion: This multidisciplinary team intervention significantly improved the time to initiation of antibiotics and procurement of sputum for patients with CAP.

Key Words: antibiotic • community-acquired pneumonia • drug delivery • quality improvement • sputum




This article has been cited by other articles:


Home page
 Journal of Pharmacy PracticeHome page
J. Hara and S. Stone
Antibiotics for Life-Threatening Illness
Journal of Pharmacy Practice, October 1, 2005; 18(5): 336 - 350.
[Abstract] [PDF]

Home page
 J Antimicrob ChemotherHome page
J. A. Schouten, M. E. Hulscher, B.-J. Kullberg, A. Cox, I. C. Gyssens, J. W. van der Meer, and R. P. Grol
Understanding variation in quality of antibiotic use for community-acquired pneumonia: effect of patient, professional and hospital factors
J. Antimicrob. Chemother., September 1, 2005; 56(3): 575 - 582.
[Abstract] [Full Text] [PDF]

Home page
 Arch Intern MedHome page
E. Garcia-Vazquez, M. A. Marcos, J. Mensa, A. de Roux, J. Puig, C. Font, G. Francisco, and A. Torres
Assessment of the Usefulness of Sputum Culture for Diagnosis of Community-Acquired Pneumonia Using the PORT Predictive Scoring System
Arch Intern Med, September 13, 2004; 164(16): 1807 - 1811.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
L. M. Mundy, T. L. Leet, K. Darst, M. A. Schnitzler, and W. C. Dunagan
Early Mobilization of Patients Hospitalized With Community-Acquired Pneumonia
Chest, September 1, 2003; 124(3): 883 - 889.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2002 by the American College of Chest Physicians.