期刊
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE
卷 5, 期 3, 页码 616-+出版社
ELSEVIER SCIENCE BV
DOI: 10.1016/j.jaip.2017.02.019
关键词
Policy; Guideline; Stewardship; Adverse drug reaction; Hypersensitivity; Allergy; Beta-lactam; Drug; Penicillin; Test dose; Graded challenges; Quality improvement
资金
- Partners HealthCare Quality, Safety and Value
- Clinical Process Improvement Leadership Program
- National Institutes of Health [K01AI125631-01]
- American Academy of Allergy, Asthma and Immunology (AAAAI) Foundation
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. (C) 2017 American Academy of Allergy, Asthma & Immunology
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