Computer surveillance of hospital-acquired infections and antibiotic use.

Surveillance of hospital-acquired infections and antibiotic use is required of US hospitals. The time and cost needed to actively perform this surveillance can be extensive. We developed a computerized infectious disease monitor that automatically generates four types of surveillance "alerts" for patients with hospital-acquired infections, not receiving antibiotics to which their pathogens are susceptible, who could be receiving less expensive antibiotics, or who are receiving prophylactic antibiotics too long. Surveillance personnel using computer screening for two months found more hospital-acquired infections when compared with our traditional surveillance methods, while requiring only 35% of the time. In addition, alerts from the computer identified 37 patients not receiving appropriate antibiotics, 31 patients who could have been receiving less expensive antibiotics, and 142 patients, during one month, receiving prolonged cephalosporin prophylaxis. Computer screening can help focus the activities and improve the efficiency of hospital surveillance personnel.

Computerized medication monitoring system.

A computerized medication monitoring system for alerting and warning of potential adverse drug reactions is described. The system integrates computerized data on each hospital patient (medications, clinical laboratory, blood gas, ECG, ALLERGIES, DIAGNOSIs, etc.) and returns to the pharmacist warning messages and suggestions regarding patient drug therapy. The broad data base allows for nearly complete drug therapy monitoring. When a warning message is received, the pharmacist contacts the physician or nursing staff and explains the potential problem. The system also generates prescription labels and patient drug profiles which are used in a unit dose dispensing system. Five percent of 13,727 patients monitored have had drug alerts. Of these alterts, 44.9% were drug-laboratory contraindications and only 28.9% were drug-drug interactions. Of the 690 alerts received, 77% resulted in the physician changing the patient's therapy.