1. A pre-postintervention study to evaluate the impact of dose calculators on the accuracy of gentamicin and vancomycin initial doses
- Author
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Cate Whittlesea, Paul Wade, Gillian Cavell, Anas Hamad, and James Hinton
- Subjects
Adult ,Male ,medicine.medical_specialty ,Vancomycin Dose ,Gentamicin Dose ,Drug Prescriptions ,Vancomycin ,London ,Humans ,Medication Errors ,Medicine ,Prospective Studies ,Dosing ,Intensive care medicine ,Prospective cohort study ,Decision Making, Computer-Assisted ,Aged ,Retrospective Studies ,business.industry ,Research ,Retrospective cohort study ,General Medicine ,Middle Aged ,Decision Support Systems, Clinical ,National health service ,Quality Improvement ,Hospitals ,Anti-Bacterial Agents ,Emergency medicine ,Female ,Gentamicin ,Guideline Adherence ,Health Services Research ,Drug Monitoring ,Gentamicins ,business ,medicine.drug - Abstract
Objectives: Gentamicin and vancomycin are narrowtherapeutic-index antibiotics with potential for high toxicity requiring dose individualisation and continuous monitoring. Clinical decision support (CDS) tools have been effective in reducing gentamicin and vancomycin dosing errors. Online dose calculators for these drugs were implemented in a London National Health Service hospital. This study aimed to evaluate the impact of these calculators on the accuracy of gentamicin and vancomycin initial doses. Methods: The study used a pre–postintervention design. Data were collected using electronic patient records and paper notes. Random samples of gentamicin and vancomycin initial doses administered during the 8 months before implementation of the calculators were assessed retrospectively against hospital guidelines. Following implementation of the calculators, doses were assessed prospectively. Any gentamicin dose not within ±10% and any vancomycin dose not within ±20% of the guideline-recommended dose were considered incorrect. Results: The intranet calculator pages were visited 721 times (gentamicin=333; vancomycin=388) during the 2-month period following the calculators’ implementation. Gentamicin dose errors fell from 61.5% (120/195) to 44.2% (95/215), p
- Published
- 2015