Effects of staff education and standardizing dosing and collection times on vancomycin trough appropriateness in ward patients

Abstract

Background: Many institutions have guidelines for initiation and monitoring, but not timing, of vancomycin.

Objective: Our objective was to evaluate vancomycin trough collection appropriateness before and after an initiative to change the dosing and trough collection times in ward patients.

Methods: A retrospective cohort study of ward patients from May 2014-16 who received scheduled intravenous vancomycin was performed. Nurse managers and pharmacists provided staff education. Differences between pre- and post-intervention groups were compared using student's t-test for continuous data and chi-square test for categorical data.

Results: Baseline characteristics were similar between the pre-intervention (n=124) and post-intervention (n=122) groups except for weight-based maintenance dose (15.3 mg/kg vs. 16.5 mg/kg, p=0.03) and percentage of troughs collected with morning labs (14% vs. 87%, p<0.001). Patients in the pre- and post-intervention groups received a similar frequency of loading doses (14.5% vs. 16%, p=0.68). There was no significant difference in percentage of vancomycin troughs collected appropriately at 30 (40% vs. 42%, p=0.72), 60 (57% vs. 63%, p=0.35), or 75 (60% vs. 68%, p=0.22) minutes from the scheduled time of the next dose.

Conclusion: Staff education and standardizing collection of vancomycin troughs with morning blood collections did not affect the percentage of appropriately collected vancomycin troughs.

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Author Biographies

Drayton A. Hammond

Assistant Professor of Pharmacy Practice

Lexis N. Atkinson
Pharmacy Resident
Taylor B. James
Pharmacy Resident
Jacob T. Painter
Assistant Professor of Pharmacy Practice
Katherine Lusardi
Antimicrobial Stewardship Pharmacist

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Published
2017-06-30
How to Cite
HAMMOND, Drayton A. et al. Effects of staff education and standardizing dosing and collection times on vancomycin trough appropriateness in ward patients. Pharmacy Practice, [S.l.], v. 15, n. 2, p. 949, june 2017. ISSN 1886-3655. Available at: <https://www.pharmacypractice.org/journal/index.php/pp/article/view/949>. Date accessed: 17 oct. 2017.
Section
Original Research

Keywords

Vancomycin; Drug Monitoring; Pharmacists; Dose-Response Relationship, Drug; Plasma; Pharmacokinetics; Quality Improvement; Retrospective Studies; United States