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A Pilot Study of a Computerized Decision Support System to Detect Invasive Fungal Infection in Pediatric Hematology/Oncology Patients

Published online by Cambridge University Press:  17 August 2015

Adam Bartlett ,
Emma Goeman ,
Aditi Vedi ,
Mona Mostaghim ,
Toby Trahair ,
Tracey A. O’Brien ,
Pamela Palasanthiran  and
Brendan McMullan
Adam Bartlett*
Affiliation:
Department of Immunology and Infectious Diseases, Sydney Children’s Hospital, Randwick, NSW, Australia School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, Australia
Emma Goeman
Affiliation:
Department of Immunology and Infectious Diseases, Sydney Children’s Hospital, Randwick, NSW, Australia
Aditi Vedi
Affiliation:
School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, Australia Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW, Australia
Mona Mostaghim
Affiliation:
University of Technology, Sydney, Australia
Toby Trahair
Affiliation:
Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW, Australia University of New South Wales, Sydney, NSW, Australia
Tracey A. O’Brien
Affiliation:
Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW, Australia University of New South Wales, Sydney, NSW, Australia
Pamela Palasanthiran
Affiliation:
Department of Immunology and Infectious Diseases, Sydney Children’s Hospital, Randwick, NSW, Australia School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, Australia
Brendan McMullan
Affiliation:
Department of Immunology and Infectious Diseases, Sydney Children’s Hospital, Randwick, NSW, Australia School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, Australia
*
Address correspondence to Adam Bartlett, Department of Immunology and Infectious Diseases, Sydney Children’s Hospital, High Street, Randwick, NSW, Australia, 2031 (adam.bartlett@sesiahs.health.nsw.gov.au).
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Abstract

OBJECTIVE

Computerized decision support systems (CDSSs) can provide indication-specific antimicrobial recommendations and approvals as part of hospital antimicrobial stewardship (AMS) programs. The aim of this study was to assess the performance of a CDSS for surveillance of invasive fungal infections (IFIs) in an inpatient hematology/oncology cohort.

METHODS

Between November 1, 2012, and October 31, 2013, pediatric hematology/oncology inpatients diagnosed with an IFI were identified through an audit of the CDSS and confirmed by medical record review. The results were compared to hospital diagnostic-related group (DRG) coding for IFI throughout the same period.

RESULTS

A total of 83 patients were prescribed systemic antifungals according to the CDSS for the 12-month period. The CDSS correctly identified 19 patients with IFI on medical record review, compared with 10 patients identified by DRG coding, of whom 9 were confirmed to have IFI on medical record review.

CONCLUSIONS

CDSS was superior to diagnostic coding in detecting IFI in an inpatient pediatric hematology/oncology cohort. The functionality of CDSS lends itself to inpatient infectious diseases surveillance but depends on prescriber adherence.

Infect. Control Hosp. Epidemiol. 2015;36(11):1313–1317

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 36 , Issue 11 , November 2015 , pp. 1313 - 1317
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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