Table. Prescribing practice changes implemented in response to benchmark data intervention, and mean rate of vancomycin usea before and after implementation, 50 Project ICARE ICUs, January 1996–July 1999b.
Vancomycin use prescribing practice change | No. of ICUs (%) | Vancomycin use before and after practice change |
p valuec | |||
---|---|---|---|---|---|---|
(n=50) | Change absent |
Change present |
||||
Before | After | Before | After | |||
Hospitalwided | 22 (44%) | |||||
Drug use evaluation | 19 (38%) | 74.2 | 80.5 | 105.3 | 94.1 | 0.62 |
Redistributed HICPAC guidelines on VRE | 9 (18%) | 79.4 | 84.6 | 116.0 | 90.6 | 0.34 |
Prior approval of vancomycin required | 3 (6%) | 87.2 | 99.4 | 84.7 | 67.2 | 0.25 |
Unit-specificd | 11 (22%) | |||||
ICU-specific education on appropriate vancomycin use | 9 (18%) | 75.9 | 96.3 | 83.3 | 132.1 | 0.01 |
Removed vancomycin from surgical prophylaxis |
3 (6%) |
82.0 |
82.2 |
85.9 |
149.1 |
0.01 |
aDefined daily doses per 1,000 patient-days. bAbbreviations: ICARE, Intensive Care Antimicrobial Resistance Epidemiology; ICU, intensive-care units; HICPAC, Healthcare Infection control Practices Advisory Committee; VRE, vancomycin-resistant enterococci. cPaired t-test. dComponents of each major categories are not mutually exclusive, so one ICU may be represented in several components of each category. |