ArticleAntimicrobial stewardship & healthcare epidemiology : ASHE2024
Provider & nursing perspectives on the "panculture": opportunities for innovative diagnostic stewardship interventions.
Article in Antimicrobial stewardship & healthcare epidemiology : ASHE, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
2 authors.
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Abstract
Objective: To examine practices of providers and nursing staff in evaluating febrile patients and identify drivers of excessive diagnostic testing. Design: Prospective multiple-choice surveys. Setting: Inpatient areas and the Emergency Department at Rhode Island Hospital (RIH) in Providence, RI. Participants & Methods: We conducted two surveys focused on the evaluation of febrile inpatients at RIH. One survey was of providers trained in internal medicine, surgery, pediatrics, emergency medicine, and neurology; the other survey was of nursing staff (registered nurses and certified nursing assistants), in inpatient areas and the emergency department. Results: 70 providers (9%) and 178 nursing staff (12%) completed the surveys. 64% of providers (n = 43) reported "always" or "often" ordering full fever workups and 67% of providers (n = 47) reported "always" or "often" physically evaluating febrile patients. Nurses were less likely than providers to report that providers "always" or "often" physically evaluate febrile patients (n = 80, 45%; Conclusions: This study elucidates drivers of inefficient and excessive utilization of diagnostic studies and identifies targets for diagnostic stewardship interventions.
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