Evaluation of Emergency Medicine Pharmacist Impact on Blood Culture Review Following Emergency Department Discharge

Overview

Patients are commonly discharged from the Emergency Department(ED) with pending blood culture results. Blood cultures can take up to 48 hours to become positive which is why it is important to notify patients with true positive cultures as soon as possible. Delay in notification can lead to other serious complications such as sepsis, septic shock, and death. The American College of Emergency Physicians states pharmacists serve a critical role in ensuring efficient, safe, and effective medication use in the ED and advocates for health systems to support dedicated roles for pharmacists within the ED. Pharmacists help to decrease the workload on the healthcare team, especially in the ED where there is high volume and acuity.Emergency medicine pharmacist (EMP) play a significant role in the optimization of therapy, medication safety, and reducing costs. There is strong evidence for the positive impact EMPs have on microbiological culture review. Overall, pharmacist review of late cultures results in higher rates of appropriate antimicrobial therapy and decreased missed interventions.These prior studies focused on the review of microbiological tests, including sexually transmitted infections, urine, and wound cultures; however, there was limited data to support the role of pharmacists evaluating late blood culture results.

A multicenter retrospective study will be conducted at Methodist Charlton Medical Center (MCMC) and Methodist Dallas Medical Center (MDMC). The study will be conducted using the EMR to collect data from patients who were discharged and had pending blood cultures from the ED between July 1, 2022 to July 1, 2023. The variables to be collected from the Electronic medical record(EMR) are listed in Appendix B. All blood culture reviews at MCMC are reviewed, acted on, and documented by pharmacists during available hours. All blood cultures reviewed at MDMC are reviewed, acted on, and documented by charge nurses and physicians. The collection of data will begin after study approval is received by the Institutional review board(IRB).

Conditions