CU Nursing - Fall/Winter 2020 - 4

4

4

Mustafa Ozkyanak, PhD

RESEARCH
Study Suggests How
Emergency Departments
Can Reduce Antibiotic
Over Prescribing
" ONE SIZE FITS ALL " CLINICAL DECISION SUPPORT SYSTEMS USED IN
HOSPITALS NOT EFFECTIVE IN REDUCING THE NUMBER OF ANTIBIOTIC
PRESCRIPTIONS ISSUED IN EMERGENCY DEPARTMENTS By Dana Brandorff

R

esearchers at the University of Colorado College of Nursing at the
Anschutz Medical Campus found that a unique set of factors of
the emergency department (ED) makes standard Clinical Decision
Support (CDS) systems not as effective in helping to reduce antibiotic overprescribing in that environment.

Antimicrobial resistance is a major public health concern, accounting for 2.8
million infections and 35,000 deaths annually. Hospitals have focused on antibiotic stewardship programs (ASP) to reduce over prescribing of antibiotics, which
is a major contributor to antimicrobial resistance. While this has been effective
in reducing unnecessary antibiotic use by as much as 36% in inpatient settings,
EDs are an exception where approximately 10 million outpatient antibiotic
prescriptions are written annually in the US. Data show that up to 50% of the
prescriptions were inappropriate or unnecessary.
The study, published in Applied Clinical Informatics, looked at three pediatric EDs
to determine how the unique setting of the ED influences this pattern, and how
Clinical Decision Support (CDS) systems can complement professional judgment
in the ED setting and potentially reduce unnecessary antibiotic use. " The ED
is unique. Several factors are at play - clinical judgment, provider fatigue, the
busyness of the ED, workflow, technology, bed availability, social determinants
of health of the patient and their families, " said lead author Associate Professor

CU College of Nursing | Fall/ Winter 2020

Mustafa Ozkyanak, PhD. " These all impact antibiotic prescribing decisions. "
The study of 38 ED providers analyzed these and
additional factors to determine how to design a
CDS system to assist with antimicrobial stewardship in pediatric emergency departments. It
discovered that systems are rarely tailored to
the context of the ED environment and end-user
needs.
" ED clinicians often need to make rapid decisions and are frequently interrupted during
the decision-making process, " said Ozkaynak.
Current CDS systems do not take this unique
set of circumstances into account. " Significant
opportunities exist to improve the appropriateness of antibiotic prescribing in the ED setting.
Including relevant contextual data, considering
the limitations of current CDS systems, and tailoring the design and implementation could all
help in reducing unnecessary antibiotic use. "



CU Nursing - Fall/Winter 2020

Table of Contents for the Digital Edition of CU Nursing - Fall/Winter 2020

CU Nursing - Fall/Winter 2020 - Cover1
CU Nursing - Fall/Winter 2020 - 2
CU Nursing - Fall/Winter 2020 - 3
CU Nursing - Fall/Winter 2020 - 4
CU Nursing - Fall/Winter 2020 - 5
CU Nursing - Fall/Winter 2020 - 6
CU Nursing - Fall/Winter 2020 - 7
CU Nursing - Fall/Winter 2020 - 8
CU Nursing - Fall/Winter 2020 - 9
CU Nursing - Fall/Winter 2020 - 10
CU Nursing - Fall/Winter 2020 - 11
CU Nursing - Fall/Winter 2020 - 12
CU Nursing - Fall/Winter 2020 - 13
CU Nursing - Fall/Winter 2020 - 14
CU Nursing - Fall/Winter 2020 - 15
CU Nursing - Fall/Winter 2020 - 16
CU Nursing - Fall/Winter 2020 - 17
CU Nursing - Fall/Winter 2020 - 18
CU Nursing - Fall/Winter 2020 - 19
CU Nursing - Fall/Winter 2020 - 20
CU Nursing - Fall/Winter 2020 - 21
CU Nursing - Fall/Winter 2020 - 22
CU Nursing - Fall/Winter 2020 - 23
CU Nursing - Fall/Winter 2020 - 24
CU Nursing - Fall/Winter 2020 - 25
CU Nursing - Fall/Winter 2020 - 26
CU Nursing - Fall/Winter 2020 - 27
CU Nursing - Fall/Winter 2020 - 28
CU Nursing - Fall/Winter 2020 - 29
CU Nursing - Fall/Winter 2020 - 30
CU Nursing - Fall/Winter 2020 - 31
CU Nursing - Fall/Winter 2020 - Cover4
https://www.nxtbook.com/nxtbooks/ucdenver/cunursing_fallcomm22
https://www.nxtbook.com/nxtbooks/ucdenver/cunursing_springcomm22
https://www.nxtbook.com/nxtbooks/ucdenver/cunursing_springsummer22
https://www.nxtbook.com/nxtbooks/ucdenver/cunursing_commencementdecember21
https://www.nxtbook.com/nxtbooks/ucdenver/cunursing_fallwinter21
https://www.nxtbook.com/nxtbooks/ucdenver/cunursing_commencementspring21
https://www.nxtbook.com/nxtbooks/ucdenver/cunursing_springsummer21
https://www.nxtbook.com/nxtbooks/ucdenver/cunursing_commencement1220
https://www.nxtbook.com/nxtbooks/ucdenver/cunursing_fallwinter20
https://www.nxtbook.com/nxtbooks/ucdenver/cunursing_commencementspring20
https://www.nxtbook.com/nxtbooks/ucdenver/cunursing_springsummer20
https://www.nxtbook.com/nxtbooks/ucdenver/cunursing_wintergraduation19
https://www.nxtbook.com/nxtbooks/ucdenver/cunursing_fallwinter19
https://www.nxtbook.com/nxtbooks/ucdenver/cunursing_graduation19
https://www.nxtbook.com/nxtbooks/ucdenver/cunursing_springsummer19
https://www.nxtbook.com/nxtbooks/ucdenver/cunursing_graduation18
https://www.nxtbook.com/nxtbooks/ucdenver/cunursing_fallwinter18
https://www.nxtbookmedia.com