The following is a summary of “Pharmacist involvement in blood culture follow up for patients discharged from the emergency department,” published in the October 2023 issue of Emergency Medicine by Brenneman, et al.

For a study, researchers sought to assess the time to attempted patient contact for positive blood cultures in patients discharged from the Emergency Department (ED), comparing instances when an Emergency Medicine (EM) pharmacist is on-duty versus off-duty.

Conducted as a single-center, retrospective study, the research focused on discharged ED patients with subsequent positive blood cultures. A previously approved algorithm guided the review of blood cultures. The EM pharmacist, when on duty, was the designated reviewer, while charge nurses and physicians took on this responsibility when the pharmacist was off-duty. The primary outcome measured was the time from ED notification of positive blood culture gram stain to the first attempted patient contact, comparing instances when the EM pharmacist was on-duty to those when off-duty. Secondary outcomes included the appropriateness of recommendations, 30-day infection-related readmission rates, patient adherence, and barriers to patient contact. An infectious disease attending physician independently reviewed cases deviating from the algorithm.

Of the initially screened 127 patients, 71 met the inclusion criteria. Baseline demographics were comparable, except for a higher proportion of immunocompromised patients in the on-duty cohort (35.2% vs. 5.9%, P = 0.01). The median time to first attempted patient contact was significantly shorter when the pharmacist was on-duty (0.8 h [0.4–2.8]) compared to off-duty (5.6 h [1.4–11.7], P = 0.025). Pharmacists acted on 93% of all cultures, including those occurring during off-duty hours. Secondary outcomes showed no significant differences. Barriers to patient contact included the absence of active voicemail.

The study underscored that in patients discharged from the ED with subsequent positive blood cultures, the time to attempt patient contact is significantly shorter when an EM pharmacist is on-duty. It highlighted the importance of standardized practices, emphasizing the role of pharmacists in optimizing ED patient care and outcomes.

Source: sciencedirect.com/science/article/abs/pii/S0735675723003728