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Antimicrobial stewardship: The influence of behavioral nudging on renal-function–based appropriateness of dosing

Published online by Cambridge University Press:  17 June 2020

Rodrigo P. dos Santos Open the ORCID record for Rodrigo P. dos Santos [Opens in a new window] ,
Caroline Deutschendorf ,
Hellena G. Vido ,
Rafaela B. Gerson ,
Fabiane Marson ,
Melina S. Loreto ,
Tiago A. Vaz ,
André M. Avila ,
Rafael S. Scheffel  and
Thalita S. Jacoby
...Show all authors
Rodrigo P. dos Santos
Affiliation:
Infection Control Committee, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
Caroline Deutschendorf
Affiliation:
Infection Control Committee, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
Hellena G. Vido
Affiliation:
Internal Medicine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
Rafaela B. Gerson
Affiliation:
Internal Medicine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
Fabiane Marson
Affiliation:
Internal Medicine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
Melina S. Loreto
Affiliation:
Internal Medicine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
Tiago A. Vaz
Affiliation:
Information Technology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
André M. Avila
Affiliation:
Information Technology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil Digital Governance Committee, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
Rafael S. Scheffel
Affiliation:
Internal Medicine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil Medication Committee, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
Thalita S. Jacoby
Affiliation:
Medication Committee, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil Pharmacy Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
Helena B. dos Santos
Affiliation:
Quality Improvement Program, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
José Miguel Dora*
Affiliation:
Internal Medicine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil Digital Governance Committee, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
*
Author for correspondence: José Miguel Dora, E-mail: [email protected]
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Abstract

Failure to adjust doses may contribute to adverse events. We evaluated the effectiveness of providing the estimated glomerular filtration rate on appropriateness of dosing for antimicrobials. The approach increased appropriateness of dosing from 33.9% to 41.4% (P < .001). Nudging prescription behavior can boost strategies for adequate antimicrobial prescription.

Type
Concise Communication
Information
Infection Control & Hospital Epidemiology , Volume 41 , Issue 9 , September 2020 , pp. 1077 - 1079
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Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.

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References

Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. Clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl 2012;2013(3):1–150.Google Scholar
Wang, HY, Lu, CL, Wu, MP, et al.Effectiveness of an integrated CPOE decision-supporting system with clinical pharmacist monitoring practice in preventing antibiotic dosing errors. Int J Clin Pharmacol Ther 2012;50:375–382. Erratum in: Int J Clin Pharmacol Ther 2012;50:620.CrossRefGoogle ScholarPubMed
Agrawal, A.Medication errors: prevention using information technology systems. Br J Clin Pharmacol 2009;67:681–686.10.1111/j.1365-2125.2009.03427.xCrossRefGoogle ScholarPubMed
Ingram, PR, Seet, JM, Budgeon, CA, et al.Point-prevalence study of inappropriate antibiotic use at a tertiary Australian hospital. Intern Med J 2012;42:719–721.10.1111/j.1445-5994.2012.02809.xCrossRefGoogle Scholar
Goff, DA, Bauer, KA, Reed, EE, et al.Is the “low-hanging fruit” worth picking for antimicrobial stewardship programs? Clin Infect Dis 2012;55:587–592.10.1093/cid/cis494CrossRefGoogle ScholarPubMed
Crass, RL, Rodvold, KA, Mueller, BA, et al.Renal dosing of antibiotics: are we jumping the gun? Clin Infect Dis 2019;68:1596–1602.10.1093/cid/ciy790CrossRefGoogle ScholarPubMed
Grol, RP, Bosch, MC, Hulscher, ME, et al.Planning and studying improvement in patient care: the use of theoretical perspectives. Milbank Q 2007;85:93–138.10.1111/j.1468-0009.2007.00478.xCrossRefGoogle ScholarPubMed
Jones, M, Butler, J, Graber, CJ, et al.Think twice: A cognitive perspective of an antibiotic timeout intervention to improve antibiotic use. J Biomed Inform 2017;71S:S22–S31.10.1016/j.jbi.2016.06.005CrossRefGoogle ScholarPubMed
Meeker, D, Knight, TK, Friedberg, MW, et al.Nudging guideline-concordant antibiotic prescribing: a randomized clinical trial. JAMA Intern Med 2014;174:425–431.10.1001/jamainternmed.2013.14191CrossRefGoogle ScholarPubMed
Ubel, PA, Rosenthal, MB.Beyond nudges—when improving health calls for greater assertiveness. N Engl J Med 2019;380:309–311.CrossRefGoogle ScholarPubMed
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