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Addressing Inpatient Beta-Lactam Allergies: A Multihospital Implementation

2017; Elsevier BV; Volume: 5; Issue: 3 Linguagem: Inglês

10.1016/j.jaip.2017.02.019

2213-2201

Kimberly G. Blumenthal, Erica S. Shenoy, Anna R. Wolfson, David N. Berkowitz, Victoria Carballo, Diana S. Balekian, Kathleen A. Marquis, Ramy H. Elshaboury, Ronak G. Gandhi, Praveen Meka, David W. Kubiak, Jennifer Catella, Barbara B. Lambl, Joyce T. Hsu, Monique Freeley, Alana Gruszecki, Paige G. Wickner,

Antibiotics Pharmacokinetics and Efficacy

Addressing inaccurate penicillin allergies is encouraged as part of antibiotic stewardship in the inpatient setting. However, implementing interventions targeted at the 10% to 15% of inpatients reporting a previous penicillin allergy can pose substantial logistic challenges. We implemented a computerized guideline for patients with reported beta-lactam allergy at 5 hospitals within a single health care system in the Boston area. In this article, we describe our implementation roadmap, including both successes achieved and challenges faced. We explain key implementation steps, including assembling a team, stakeholder engagement, developing or selecting an approach, spreading the change, establishing measures, and measuring impact. The objective was to detail the lessons learned while empowering others to be part of this important, multidisciplinary work to improve the care of patients with reported beta-lactam allergies. Addressing inaccurate penicillin allergies is encouraged as part of antibiotic stewardship in the inpatient setting. However, implementing interventions targeted at the 10% to 15% of inpatients reporting a previous penicillin allergy can pose substantial logistic challenges. We implemented a computerized guideline for patients with reported beta-lactam allergy at 5 hospitals within a single health care system in the Boston area. In this article, we describe our implementation roadmap, including both successes achieved and challenges faced. We explain key implementation steps, including assembling a team, stakeholder engagement, developing or selecting an approach, spreading the change, establishing measures, and measuring impact. The objective was to detail the lessons learned while empowering others to be part of this important, multidisciplinary work to improve the care of patients with reported beta-lactam allergies.