Implementation of a Clinical Decision Support Alert to Increase the Number of Antibiotic Stewardship Interventions for Patients with Positive Blood Cultures During the Weekend

Introduction: 
Antimicrobial stewardship programs (ASPs) incorporate daily surveillance activities by pharmacy specialists and physicians to improve the judicious use of antimicrobials. Ideally antimicrobial stewardship services would occur every day of the week to improve patient outcomes, however historically the weekends have always presented a challenge. Typically, there are fewer pharmacists present during the weekend while the workload remains unchanged, leaving many opportunities for pharmacist-initiated antimicrobial stewardship interventions until Monday. Our aim is to increase the amount of antimicrobial stewardship interventions made during the clinical weekend by integrating a targeted clinical decision support alert for all positive BioFire FilmArray Blood Culture Identification (BCID) results into the existing clinical weekend alerts and deploying an education campaign among key participants. 

Methods: 
This is a pre-and post- implementation, quasi experimental analysis. A new clinical decision support alert will be implement to flag for all positive BCID results. Pharmacists who routinely cover weekend clinical pharmacy services will be educated on the implementation of the new alert and guidance on appropriate targeted therapy for all organisms identified.  All interventions will be recorded using an electronic database. The primary outcome will the number of interventions made on positive BCID results before and after implementation of the clinical decision support alert and pharmacist education. Secondary outcome will be time to targeted antimicrobial therapy pre- and post- implementation. Descriptive statistics will be used to characterize types of interventions and proportions of patients with positive blood culture and antimicrobial stewardship intervention documented. 

Results: 
In progress 

Conclusions: 
In progress