Q&A: Mnemonic can help assess patients for penicillin allergy
Click Here to Manage Email Alerts
Key takeaways:
- The CDC recommends that nurses improve their evaluation of penicillin allergies.
- A mnemonic device helped improve nurses’ evaluation of perioperative patients for penicillin allergy.
HOUSTON — A 6-month implementation study improved nurses’ evaluation of penicillin allergies among perioperative patients, as is recommended by the CDC for antimicrobial stewardship programs, researchers reported.
In their study, Eileen J. Carter, PhD, RN, an assistant professor at the University of Connecticut School of Nursing, and colleagues found that a mnemonic device helped nurses document patients with an allergy. They presented their findings at the Society for Healthcare Epidemiology of America Spring Conference.
The mnemonic, referred to as STORY, was printed on pocket cards for nurses. It instructed them to ask patients to describe the symptoms of a previous penicillin allergic reaction (“S”), the time that has passed since that reaction (“T”), the timing of the onset of the reaction after receiving penicillin (“O”), when symptoms resolved (“R”) and whether a patient had received penicillin “yet again” since the reaction (“Y”).
Among 426 patients, Carter and colleagues found the five STORY questions improved documentation and understanding of low-risk penicillin allergy among patients, significantly improving nurses’ and doctors’ knowledge of potential patient allergies.
We spoke with Carter about the study and the strategy’s effects on clinical outcomes.
Healio: What motivated the design and test of this implementation strategy?
Eileen Carter: We designed and tested the implementation strategy to facilitate the uptake of interventions among nurses. In previous work, we found several facilitators and barriers to nurses taking a more detailed penicillin allergy assessment. Big motivators included nurses’ desire to improve patient care.
The greatest barrier was not knowing how to take a detailed penicillin allergy history. The implementation strategy was designed to magnify these facilitators and tackle these barriers.
Healio: How did nurses feel about delivering a longer series of questions to patients? And were patients comfortable with this?
Carter: We found that nurses and patients were quite engaged in the process. In nursing focus groups, nurses acknowledged that it did take longer to go through the STORY mnemonic but felt that the extra time was worth it because their actions would ultimately benefit patients. Nurses also described that patients were intrigued by STORY questions and wanted to learn more about the initiative.
Healio: What was the overall result of the implementation strategy?
Carter: The comprehensive documentation of penicillin allergies improved in the electronic medical record, which will help to guide and optimize the patient’s future antibiotic treatments.
Healio: What should clinicians and health care administrators take away from the study’s findings?
Carter: Nurses are a key partner in antibiotic stewardship and may propel antibiotic stewardship efforts.
Our implementation strategy provides the nuts and bolts for how to engage nurses in improving the comprehensive assessment of penicillin allergies. A manuscript of study findings and the implementation strategy is underway.
Collapse
Carter E, et al. Abstract 42. Presented at: Society for Healthcare Epidemiology of America Spring Conference; April 16-19; Houston.
Click Here to Manage Email Alerts