MedPath

Clinical Decision Support Tools for Antibiotic Prescribing

Not Applicable
Completed
Conditions
Infectious Disease
Interventions
Other: Visualization tool
Registration Number
NCT03580603
Lead Sponsor
Beth Israel Deaconess Medical Center
Brief Summary

The goal of this study is to assess the utility of a data visualization tool for providers' understanding patients' past microbiological culture sensitivities. Providers that are ordering antibiotics for patients with previous culture data in the medical record will be asked to answer questions regarding past sensitivity results. They will be randomized to either using the visualization tool before answering the questions or using the standard medical record tools. They will then be surveyed about their decision-making, knowledge, and the usefulness of the tool.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
273
Inclusion Criteria
  • provider is caring for a patient with a previous positive urine or blood cultures
  • provider is caring for a patient currently in a clinical location being investigated
  • provider is caring for a patient with orders placed for an intravenous, intramuscular, oral antibiotics
Exclusion Criteria
  • the patient has already received the antibiotic by the time of the intervention
  • the antibiotic has been cancelled by the time of intervention
  • the research assistant is unable to reach the ordering provider before the visit is completed
  • participation by the clinician in the study would impede clinical care
  • age < 18

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Antibiotic visualization toolVisualization toolProvider will answer microbiological sensitivity questions using a new antibiotic visualization tool.
Primary Outcome Measures
NameTimeMethod
Provider knowledgeTo be assessed at the time of patient enrollment, up to one day after the initial antibiotic is ordered.

Provider knowledge of patients' previous culture sensitivity results as determined by the proportion of correct answers on a questionnaire:

Do you think this patient has had previous resistance to each of these antibiotics at BIDMC (Beth Israel Deaconess Medical Center)?

\[List of the top 4 antibiotic classes to which resistance is seen at BIDMC that the patient has previously had tested for antibiotic sensitivities\]

Yes (previous organisms resistant or with intermediate resistance)

No (no previous resistance noted)

Secondary Outcome Measures
NameTimeMethod
Post-intervention surveyTo be assessed at the time of patient enrollment, up to one day after the initial antibiotic is ordered.

Providers will be asked survey questions regarding their decision-making and the usability and usefulness of the tool using a 5 point Likert scale:

I understand the previous culture data for this patient (Strongly disagree) 1 2 3 4 5 (Strongly agree)

I feel like I made an informed antibiotic choice (Strongly disagree) 1 2 3 4 5 (Strongly agree)

The tool provided new information that you were not previously aware of (Strongly disagree) 1 2 3 4 5 (Strongly agree)

The tool enabled you to more quickly understand this patient's microbiological data (Strongly disagree) 1 2 3 4 5 (Strongly agree)

The tool was easy to use (Strongly disagree) 1 2 3 4 5 (Strongly agree)

Antibiotic order changesTo be assessed at the time of patient enrollment + 1 day

Antibiotic orders that are not complete by the time of the intervention will be monitored for any cancellation or change in orders

Final culture resultsTo be assessed at the time of patient enrollment + 1 week

Final culture results drawn from that visit will be compared to antibiotic orders for effectiveness

Trial Locations

Locations (1)

Beth Israel Deaconess Medical Center

🇺🇸

Boston, Massachusetts, United States

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