Decreasing review and notification times of genital and urine cultures in a pediatric emergency department: An observational before and after study

Objectives: The review of positive culture results by clinical pharmacists in pediatric patients discharged from the emergency department (ED) has not been described. This study aimed to compare review and family notification times of genital and urine cultures before and after initiation of review of positive cultures by clinical pharmacists in a pediatric ED. Methods: This was a retrospective review of charts for the study period of 1 year before and 1 year after initiation of review of positive cultures by clinical pharmacists. Positive culture timing results as well as types and rates of interventions were obtained from the electronic chart records. Results: A total of 681 urine and 171 genital cultures were analyzed. The number of genital and urine cultures were similar in the nurse-driven and pharmacist-driven periods. For urine cultures, the cumulative percentage of notifications in the pharmacist-driven period exceeded that in the nurse-driven period until about 24 hours and again between 24 and 48 hours. By 12 hours, 5.4% of families had been notified in the pharmacist-driven period compared with 1.8% in the nurse-driven period (P = 0.011). More positive cultures were reviewed early in the pharmacist-driven period as well, but by 12 hours, the cumulative percentages were similar: 30.4% in the pharmacist-driven period compared with 27.7% in the nurse-driven period (P = 0.431). For genital cultures, the distribution of notification and review times were similar in both periods. Conclusions: The review of positive cultures by clinical pharmacists in a pediatric ED can shorten review and notification times compared with nurses, especially in the first 12 hours.