Addressing Inpatient Beta-Lactam Allergies: A Multihospital Implementation
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 compute...
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| Veröffentlicht in: | The journal of allergy and clinical immunology in practice (Cambridge, MA) MA), 2017-05, Vol.5 (3), p.616-625.e7 |
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| container_title | The journal of allergy and clinical immunology in practice (Cambridge, MA) |
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| creator | Blumenthal, Kimberly G., MD, MSc Shenoy, Erica S., MD, PhD Wolfson, Anna R., MD Berkowitz, David N., PharmD Carballo, Victoria A., MPH Balekian, Diana S., MD, MPH Marquis, Kathleen A., PhD, PharmD Elshaboury, Ramy, PharmD, BCPS, AQID Gandhi, Ronak G., PharmD, BCPS Meka, Praveen, MD, MBA Kubiak, David W., PharmD, BCPS, AQID Catella, Jennifer, PharmD, BCPS Lambl, Barbara B., MD, MPH Hsu, Joyce T., MD Freeley, Monique M., RPh Gruszecki, Alana, PharmD, RPh, BCPS Wickner, Paige G., MD, MPH |
| description | 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. |
| doi_str_mv | 10.1016/j.jaip.2017.02.019 |
| format | Article |
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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.</description><identifier>ISSN: 2213-2198</identifier><identifier>EISSN: 2213-2201</identifier><identifier>DOI: 10.1016/j.jaip.2017.02.019</identifier><identifier>PMID: 28483315</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adverse drug reaction ; Allergies ; Allergy ; Allergy and Immunology ; Antibiotics ; Antimicrobial agents ; Asthma ; Beta-lactam ; beta-Lactams - adverse effects ; beta-Lactams - therapeutic use ; Boston ; Collaboration ; Disease control ; Disease prevention ; Drug ; Drug Hypersensitivity - diagnosis ; Drug stores ; Electronic health records ; Graded challenges ; Guideline ; Health care policy ; Hospitals ; Humans ; Hypersensitivity ; Immunology ; Infections ; Infectious diseases ; Inpatients ; Internal Medicine ; Leadership ; Medicine ; Patient safety ; Penicillin ; Pharmacists ; Policy ; Practice Guidelines as Topic ; Quality improvement ; Quality standards ; Skin Tests ; Stewardship ; Teams ; Test dose ; Trends</subject><ispartof>The journal of allergy and clinical immunology in practice (Cambridge, MA), 2017-05, Vol.5 (3), p.616-625.e7</ispartof><rights>American Academy of Allergy, Asthma & Immunology</rights><rights>2017 American Academy of Allergy, Asthma & Immunology</rights><rights>Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited May 1, 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c483t-b06d3360d79bbc282c99b90546bf2bc4bf1f908d630a50d0619530374ea658e63</citedby><cites>FETCH-LOGICAL-c483t-b06d3360d79bbc282c99b90546bf2bc4bf1f908d630a50d0619530374ea658e63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28483315$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Blumenthal, Kimberly G., MD, MSc</creatorcontrib><creatorcontrib>Shenoy, Erica S., MD, PhD</creatorcontrib><creatorcontrib>Wolfson, Anna R., MD</creatorcontrib><creatorcontrib>Berkowitz, David N., PharmD</creatorcontrib><creatorcontrib>Carballo, Victoria A., MPH</creatorcontrib><creatorcontrib>Balekian, Diana S., MD, MPH</creatorcontrib><creatorcontrib>Marquis, Kathleen A., PhD, PharmD</creatorcontrib><creatorcontrib>Elshaboury, Ramy, PharmD, BCPS, AQID</creatorcontrib><creatorcontrib>Gandhi, Ronak G., PharmD, BCPS</creatorcontrib><creatorcontrib>Meka, Praveen, MD, MBA</creatorcontrib><creatorcontrib>Kubiak, David W., PharmD, BCPS, AQID</creatorcontrib><creatorcontrib>Catella, Jennifer, PharmD, BCPS</creatorcontrib><creatorcontrib>Lambl, Barbara B., MD, MPH</creatorcontrib><creatorcontrib>Hsu, Joyce T., MD</creatorcontrib><creatorcontrib>Freeley, Monique M., RPh</creatorcontrib><creatorcontrib>Gruszecki, Alana, PharmD, RPh, BCPS</creatorcontrib><creatorcontrib>Wickner, Paige G., MD, MPH</creatorcontrib><title>Addressing Inpatient Beta-Lactam Allergies: A Multihospital Implementation</title><title>The journal of allergy and clinical immunology in practice (Cambridge, MA)</title><addtitle>J Allergy Clin Immunol Pract</addtitle><description>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.</description><subject>Adverse drug reaction</subject><subject>Allergies</subject><subject>Allergy</subject><subject>Allergy and Immunology</subject><subject>Antibiotics</subject><subject>Antimicrobial agents</subject><subject>Asthma</subject><subject>Beta-lactam</subject><subject>beta-Lactams - adverse effects</subject><subject>beta-Lactams - therapeutic use</subject><subject>Boston</subject><subject>Collaboration</subject><subject>Disease control</subject><subject>Disease prevention</subject><subject>Drug</subject><subject>Drug Hypersensitivity - diagnosis</subject><subject>Drug stores</subject><subject>Electronic health records</subject><subject>Graded challenges</subject><subject>Guideline</subject><subject>Health care policy</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypersensitivity</subject><subject>Immunology</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Inpatients</subject><subject>Internal Medicine</subject><subject>Leadership</subject><subject>Medicine</subject><subject>Patient safety</subject><subject>Penicillin</subject><subject>Pharmacists</subject><subject>Policy</subject><subject>Practice Guidelines as Topic</subject><subject>Quality improvement</subject><subject>Quality standards</subject><subject>Skin Tests</subject><subject>Stewardship</subject><subject>Teams</subject><subject>Test dose</subject><subject>Trends</subject><issn>2213-2198</issn><issn>2213-2201</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kV9v1SAYhxujccvcF_DCNPHGm9YXaCkYY3Jc1J3lGC_Ua0Lh7aTSP0Jrsm8vzdlcsotxAyHP7wc8ZNlLAiUBwt_2Za_dXFIgTQm0BCKfZKeUElbQtPf0bk2kOMnOY-whDUEaqOB5dkJFJRgj9Wl2tbM2YIxuvM7346wXh-OSf8RFFwdtFj3kO-8xXDuM7_Jd_nX1i_s1xdkt2uf7YfY4pECKTeOL7FmnfcTz2_ks-_n504-Ly-Lw7cv-YncoTDp0KVrgljEOtpFta6igRspWQl3xtqOtqdqOdBKE5Qx0DRY4kTUD1lSoeS2Qs7PszbF3DtOfFeOiBhcNeq9HnNaoiJBcSNbIKqGvH6D9tIYx3W6j6hqSSZYoeqRMmGIM2Kk5uEGHG0VAbbJVrzbZapOtgKokO4Ve3Vav7YD2f-RObQLeHwFMLv46DCqaJNegdQHNouzkHu__8CBuvBud0f433mC8f4eKKaC-b9-9_TZpWGqsKPsHQruirw</recordid><startdate>20170501</startdate><enddate>20170501</enddate><creator>Blumenthal, Kimberly G., MD, MSc</creator><creator>Shenoy, Erica S., MD, PhD</creator><creator>Wolfson, Anna R., MD</creator><creator>Berkowitz, David N., PharmD</creator><creator>Carballo, Victoria A., MPH</creator><creator>Balekian, Diana S., MD, MPH</creator><creator>Marquis, Kathleen A., PhD, PharmD</creator><creator>Elshaboury, Ramy, PharmD, BCPS, AQID</creator><creator>Gandhi, Ronak G., PharmD, BCPS</creator><creator>Meka, Praveen, MD, MBA</creator><creator>Kubiak, David W., PharmD, BCPS, AQID</creator><creator>Catella, Jennifer, PharmD, BCPS</creator><creator>Lambl, Barbara B., MD, MPH</creator><creator>Hsu, Joyce T., MD</creator><creator>Freeley, Monique M., RPh</creator><creator>Gruszecki, Alana, PharmD, RPh, BCPS</creator><creator>Wickner, Paige G., MD, MPH</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20170501</creationdate><title>Addressing Inpatient Beta-Lactam Allergies: A Multihospital Implementation</title><author>Blumenthal, Kimberly G., MD, MSc ; Shenoy, Erica S., MD, PhD ; Wolfson, Anna R., MD ; Berkowitz, David N., PharmD ; Carballo, Victoria A., MPH ; Balekian, Diana S., MD, MPH ; Marquis, Kathleen A., PhD, PharmD ; Elshaboury, Ramy, PharmD, BCPS, AQID ; Gandhi, Ronak G., PharmD, BCPS ; Meka, Praveen, MD, MBA ; Kubiak, David W., PharmD, BCPS, AQID ; Catella, Jennifer, PharmD, BCPS ; Lambl, Barbara B., MD, MPH ; Hsu, Joyce T., MD ; Freeley, Monique M., RPh ; Gruszecki, Alana, PharmD, RPh, BCPS ; Wickner, Paige G., MD, MPH</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c483t-b06d3360d79bbc282c99b90546bf2bc4bf1f908d630a50d0619530374ea658e63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adverse drug reaction</topic><topic>Allergies</topic><topic>Allergy</topic><topic>Allergy and Immunology</topic><topic>Antibiotics</topic><topic>Antimicrobial agents</topic><topic>Asthma</topic><topic>Beta-lactam</topic><topic>beta-Lactams - adverse effects</topic><topic>beta-Lactams - therapeutic use</topic><topic>Boston</topic><topic>Collaboration</topic><topic>Disease control</topic><topic>Disease prevention</topic><topic>Drug</topic><topic>Drug Hypersensitivity - diagnosis</topic><topic>Drug stores</topic><topic>Electronic health records</topic><topic>Graded challenges</topic><topic>Guideline</topic><topic>Health care policy</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hypersensitivity</topic><topic>Immunology</topic><topic>Infections</topic><topic>Infectious diseases</topic><topic>Inpatients</topic><topic>Internal Medicine</topic><topic>Leadership</topic><topic>Medicine</topic><topic>Patient safety</topic><topic>Penicillin</topic><topic>Pharmacists</topic><topic>Policy</topic><topic>Practice Guidelines as Topic</topic><topic>Quality improvement</topic><topic>Quality standards</topic><topic>Skin Tests</topic><topic>Stewardship</topic><topic>Teams</topic><topic>Test dose</topic><topic>Trends</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Blumenthal, Kimberly G., MD, MSc</creatorcontrib><creatorcontrib>Shenoy, Erica S., MD, PhD</creatorcontrib><creatorcontrib>Wolfson, Anna R., MD</creatorcontrib><creatorcontrib>Berkowitz, David N., PharmD</creatorcontrib><creatorcontrib>Carballo, Victoria A., MPH</creatorcontrib><creatorcontrib>Balekian, Diana S., MD, MPH</creatorcontrib><creatorcontrib>Marquis, Kathleen A., PhD, PharmD</creatorcontrib><creatorcontrib>Elshaboury, Ramy, PharmD, BCPS, AQID</creatorcontrib><creatorcontrib>Gandhi, Ronak G., PharmD, BCPS</creatorcontrib><creatorcontrib>Meka, Praveen, MD, MBA</creatorcontrib><creatorcontrib>Kubiak, David W., PharmD, BCPS, AQID</creatorcontrib><creatorcontrib>Catella, Jennifer, PharmD, BCPS</creatorcontrib><creatorcontrib>Lambl, Barbara B., MD, MPH</creatorcontrib><creatorcontrib>Hsu, Joyce T., MD</creatorcontrib><creatorcontrib>Freeley, Monique M., RPh</creatorcontrib><creatorcontrib>Gruszecki, Alana, PharmD, RPh, BCPS</creatorcontrib><creatorcontrib>Wickner, Paige G., MD, MPH</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of allergy and clinical immunology in practice (Cambridge, MA)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Blumenthal, Kimberly G., MD, MSc</au><au>Shenoy, Erica S., MD, PhD</au><au>Wolfson, Anna R., MD</au><au>Berkowitz, David N., PharmD</au><au>Carballo, Victoria A., MPH</au><au>Balekian, Diana S., MD, MPH</au><au>Marquis, Kathleen A., PhD, PharmD</au><au>Elshaboury, Ramy, PharmD, BCPS, AQID</au><au>Gandhi, Ronak G., PharmD, BCPS</au><au>Meka, Praveen, MD, MBA</au><au>Kubiak, David W., PharmD, BCPS, AQID</au><au>Catella, Jennifer, PharmD, BCPS</au><au>Lambl, Barbara B., MD, MPH</au><au>Hsu, Joyce T., MD</au><au>Freeley, Monique M., RPh</au><au>Gruszecki, Alana, PharmD, RPh, BCPS</au><au>Wickner, Paige G., MD, MPH</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Addressing Inpatient Beta-Lactam Allergies: A Multihospital Implementation</atitle><jtitle>The journal of allergy and clinical immunology in practice (Cambridge, MA)</jtitle><addtitle>J Allergy Clin Immunol Pract</addtitle><date>2017-05-01</date><risdate>2017</risdate><volume>5</volume><issue>3</issue><spage>616</spage><epage>625.e7</epage><pages>616-625.e7</pages><issn>2213-2198</issn><eissn>2213-2201</eissn><abstract>Addressing inaccurate penicillin allergies is encouraged as part of antibiotic stewardship in the inpatient setting. 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| ispartof | The journal of allergy and clinical immunology in practice (Cambridge, MA), 2017-05, Vol.5 (3), p.616-625.e7 |
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| subjects | Adverse drug reaction Allergies Allergy Allergy and Immunology Antibiotics Antimicrobial agents Asthma Beta-lactam beta-Lactams - adverse effects beta-Lactams - therapeutic use Boston Collaboration Disease control Disease prevention Drug Drug Hypersensitivity - diagnosis Drug stores Electronic health records Graded challenges Guideline Health care policy Hospitals Humans Hypersensitivity Immunology Infections Infectious diseases Inpatients Internal Medicine Leadership Medicine Patient safety Penicillin Pharmacists Policy Practice Guidelines as Topic Quality improvement Quality standards Skin Tests Stewardship Teams Test dose Trends |
| title | Addressing Inpatient Beta-Lactam Allergies: A Multihospital Implementation |
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