Using CDSS FOR Appropriate Dosing of Antibiotics with Reduced Renal Function. Presented By: Kwavi Agbeyegbe, Sam Ruffing, Michael Peterson MED INF 406-DL FALL 2010. Identify the Problem.
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Using CDSS FOR Appropriate Dosing of Antibiotics with Reduced Renal Function
Kwavi Agbeyegbe, Sam Ruffing, Michael Peterson
MED INF 406-DL FALL 2010
Renal Function Decreasing as patients get older (COOK, 2007)
Different Calculation Methods: Glomular Filtration Rate (GFR), Creatinine Clearance (CrCl)
HMS Nursing Doc
EPIC Beaker LIS
EPIC uses HL7, ANSI X 12, XML
HMS is ODBC
Real time interface
TheraDoc-HL7, LOINC, NHSN, PHIN, MS, SNOMED-CT and Rx Norm
1. Physician selects an Antibiotic-Initial Order
4. Physician selects agree/change
If order selection is changed drop down box with reasons will require completion
Once order is completed:
Peak and trough dates and times will be ordered
eMAR will populate Antibiotic
Selections with peak and trough draw times
3. Recommendations include
Antibiotic dosage/ selection
Peak / trough levels ordered
Repeat BUN/Creatinine ordered
To : Physician and Pharmacist
Micro results on culture and sensitivity with new recommendations for Antibiotic choice, if appropriate
Alerts for peak and trough times for drawing
Alerts from nursing documentation/Lab that may signal signs and symptoms of toxicity
Verification levels with corresponding Validation tests.
Under-testing vs Over-testing
Benefits of Verification and Validation
prior, during and after implementation.