eStar updates and changes announced

The latest changes and updates to eStar:

 Pediatric Blood Volumes

To improve yield of pediatric blood cultures, VCH will begin collecting weight-based blood volumes for blood cultures.  The change, which went into effect February 5, will bring VCH in line with broader laboratory standards and will be consistent with practices in many children’s hospitals.

Once users place an order for a pediatric blood culture, eStar will provide process instructions noting the recommended blood volume to be drawn based on the patient’s weight. If no weight is documented, then the user will receive a hard stop and the order will not be able to be placed until the weight is added. The blood volume on the instructions is a recommendation, not a requirement.

Specific questions or concerns may be directed to Ritu Banerjee with Pediatric Infectious Diseases.

Nicardipine Infusion Titrations

In October 2019, a VUMC-wide pilot of a new infusion titration format for nicardipine infusion (which only affected “titration allowed" dosing) went into effect. Based on feedback from the pilot, a format change was designed. The update, which went into effect February 5, will assist in more efficient workflows for providers, pharmacy employees and nursing colleagues, when processing and administering specific titrated infusions.

Please see the Tip Sheet “Inpatient Provider: Ordering Nicardipine Infusion for Titration” (available in Hubbl) for more information.

Documentation of Antimicrobial Stewardship Recommendations

Beginning February 3, recommendations of the Vanderbilt Antimicrobial Stewardship Program (VASP) will now be documented in eStar as part of the electronic medical record. This change will affect all prescribers with eStar access.

The documentation will help increase visibility, reduce potential communication errors, and align with risk prevention priorities. VASP monitors antimicrobial use to optimize patient safety and minimize antimicrobial-related adverse events.

Recommendations will:

• Appear as a Progress Note with AMS, Antimicrobial Stewardship as the selected specialty
• Include a brief clinical summary, VASP recommendation and rationale, as well as how the recommendation was initially communicated (e.g., phone, in person)
• Not take the place of a formal Infectious Diseases consult and must be considered alongside additional clinical information

The note will include contact numbers for additional questions.

Users may refer to the Vanderbilt Antimicrobial Stewardship Program (VASP) website https://www.vumc.org/vasp/ for more information.