Evaluation of Emergency Medicine Pharmacist Impact on Blood Culture Review Following Emergency Department Discharge

NCT07486362 | Recruiting

• 1 other identifier: 057.PHA.2023.A
• Study Type: observational
• Target: 126
• Locations: 1 country
• Sites: 1

Brief Summary

Patients are commonly discharged from the Emergency Department(ED) with pending blood culture results. Blood cultures can take up to 48 hours to become positive which is why it is important to notify patients with true positive cultures as soon as possible. Delay in notification can lead to other serious complications such as sepsis, septic shock, and death. The American College of Emergency Physicians states pharmacists serve a critical role in ensuring efficient, safe, and effective medication use in the ED and advocates for health systems to support dedicated roles for pharmacists within the ED. Pharmacists help to decrease the workload on the healthcare team, especially in the ED where there is high volume and acuity.Emergency medicine pharmacist (EMP) play a significant role in the optimization of therapy, medication safety, and reducing costs. There is strong evidence for the positive impact EMPs have on microbiological culture review. Overall, pharmacist review of late cultures results in higher rates of appropriate antimicrobial therapy and decreased missed interventions.These prior studies focused on the review of microbiological tests, including sexually transmitted infections, urine, and wound cultures; however, there was limited data to support the role of pharmacists evaluating late blood culture results.

Conditions

Bacteremia

Outcome Measures

Primary Outcomes (1)

• Time from an actionable positive blood culture to the time of review and/or patient notification. ult.

  Time to patient notification is defined as time until the first attempt to contact the patient regarding the actionable positive res

  18 months

Study Arms (2)

Emergency medicine pharmacist (EMPs)

EMPs, utilizing a Collaborative practice agreements(CPA), will be associated with a significantly shorter time to patient review and notification of positive blood culture compared to a CN-physician review.

Other: No Intervention

Charge nurse (CN's)

To determine the effect of EMPs, utilizing a CPA, on the appropriateness of antibiotic selection upon return admission for bacteremia, reasons for patient return to hospital (i.e., return due to call - expectant, worsening of symptoms - non-expectant, other) compared to the standard CN-physician facilitated process, and rates of inappropriate call backs for reassessment or admissions (i.e., contaminant call backs).

Other: No Intervention

Interventions

No Intervention OTHER

No Intervention

Charge nurse (CN's); Emergency medicine pharmacist (EMPs)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients with a positive blood culture result, collected during the initial ED visit and who were discharged from the ED to the outpatient/long-term care setting prior to a critical blood Groupsculture result.

You may qualify if:

• Patients with a positive blood culture result, collected during the initial ED visit and who were discharged from the ED to the outpatient/long-term care setting prior to a critical blood Groups culture result.

You may not qualify if:

• Patients admitted to inpatient and patients transferred from ED to another acute care facility.

Sponsors & Collaborators

• Methodist Health System: lead

Study Sites (1)

Clinical Research Institute Methodist Health System

Dallas, Texas, 75203, United States

RECRUITING

MeSH Terms

Conditions

Bacteremia

Condition Hierarchy (Ancestors)

Bacterial Infections; Bacterial Infections and Mycoses; Infections; Sepsis; Systemic Inflammatory Response Syndrome; Inflammation; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Andrew Karpisek, MD

  Methodist Health System

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Crystee Cooper, DHEd

CONTACT

214-947-1280; clinicalresearch@mhd.com

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: OTHER
• Target Duration: 6 Months
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 26, 2024
• First Posted: March 20, 2026
• Study Start: January 31, 2024
• Primary Completion (Estimated): January 31, 2027
• Study Completion (Estimated): January 31, 2028
• Last Updated: March 20, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)