Journal article
Enhancing Drug Hypersensitivity Reaction Documentation Through a Clinical Surveillance Tool
Journal for healthcare quality, Vol.47(3), e0481
07/2025
DOI: 10.1097/JHQ.0000000000000481
PMID: 40424160
Abstract
Drug hypersensitivity reactions (DHRs) are potentially life-threatening, immune-mediated responses resulting from use of a medicinal product often requiring emergency department (ED) triage. For patient safety, DHR documentation in the electronic health record (EHR) is imperative-ensuring the health care team is alerted to patient risks with the offending drug. A Veterans Affairs Health Care System medication safety team uncovered that only 25.6% of patients treated for a DHR in their local ED had appropriate documentation of the DHR. To address this critical issue, a Quality Improvement (QI) project was designed with the aim of using a clinical surveillance tool to increase the DHR documentation rate in a single VA ED from 25.6% to ≥ 50% over 6 months. The DHR documentation rate was measured monthly and calculated by dividing the number of patients with appropriate DHR documentation after an ED visit for treatment of the DHR by the total number of patients visiting the ED for DHR treatment. Six months of postintervention data revealed an increase in appropriate DHR to 65.4%, through Exponentially Weighted Moving Averages Statistical Process Control analyses. This pharmacist-led QI project uses software already available at many institutions and illustrates one low-cost solution to address underreported DHRs.ABSTRACTDrug hypersensitivity reactions (DHRs) are potentially life-threatening, immune-mediated responses resulting from use of a medicinal product often requiring emergency department (ED) triage. For patient safety, DHR documentation in the electronic health record (EHR) is imperative-ensuring the health care team is alerted to patient risks with the offending drug. A Veterans Affairs Health Care System medication safety team uncovered that only 25.6% of patients treated for a DHR in their local ED had appropriate documentation of the DHR. To address this critical issue, a Quality Improvement (QI) project was designed with the aim of using a clinical surveillance tool to increase the DHR documentation rate in a single VA ED from 25.6% to ≥ 50% over 6 months. The DHR documentation rate was measured monthly and calculated by dividing the number of patients with appropriate DHR documentation after an ED visit for treatment of the DHR by the total number of patients visiting the ED for DHR treatment. Six months of postintervention data revealed an increase in appropriate DHR to 65.4%, through Exponentially Weighted Moving Averages Statistical Process Control analyses. This pharmacist-led QI project uses software already available at many institutions and illustrates one low-cost solution to address underreported DHRs.
Details
- Title: Subtitle
- Enhancing Drug Hypersensitivity Reaction Documentation Through a Clinical Surveillance Tool
- Creators
- Jennifer Meyer Reid - Lexington VA Health Care SystemKarla L Miller - University of UtahBrant Oliver - Dartmouth Institute for Health Policy and Clinical PracticeMelissa Swee - Iowa City VA Health Care SystemJaime R Wilson
- Resource Type
- Journal article
- Publication Details
- Journal for healthcare quality, Vol.47(3), e0481
- DOI
- 10.1097/JHQ.0000000000000481
- PMID
- 40424160
- NLM abbreviation
- J Healthc Qual
- ISSN
- 1945-1474
- eISSN
- 1945-1474
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Grant note
- Department of Veterans Affairs, Veterans Health Administration, Office of Rural Health, Veterans Rural Health Resource Center-Iowa City, ORH Rural Scholars Fellowship Program: NOMAD PROJ-03808 Lexington VA Health Care SystemDepartment of Veterans Affairs, Veterans Health Administration, Office of Academic Affiliations VA Quality Scholars Advanced Fellowship Program
This material is based on work supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Rural Health, Veterans Rural Health Resource Center-Iowa City, ORH Rural Scholars Fellowship Program[NOMAD PROJ-03808]. This work was supported in part by the Lexington VA Health Care System and the Department of Veterans Affairs, Veterans Health Administration, Office of Academic Affiliations VA Quality Scholars Advanced Fellowship Program. The views expressed are those of the authors and donot necessarily reflect the position or policy of the Department of VeteransAffairs or the U.S. government.
- Language
- English
- Electronic publication date
- 05/23/2025
- Date published
- 07/2025
- Academic Unit
- Nursing; Nephrology; Internal Medicine
- Record Identifier
- 9984824179002771
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