11 measures Antibiotic

Stewardship• #66: Pharyngitis patients

given an abx who had strep test performed

• #91: Patients with Otitis Externa given a topical abx

• #93: Patients with Otitis Externa not given a systemic abx

• #116: 18-64 y/o with bronchitis not given abxwithin 3 days of encounter

Choosing Wisely:Head CT Utilization

• #416: 2-17 y/o with appropriate head CT for blunt head trauma (PECARN rules)

• #415: 18+ y/o with appropriate head CT ordering for blunt head trauma

PregnancyMeasures

• #254: US localization of pregnancy in pregnant pts with abd pain

• #255: Rhogam for Rh negative patients at risk

Miscellaneous

• #54: EKG for non-traumatic chest pain

• #76: Proper sterile technique for CVC placement

• #317: BP Screening and follow up documented

#255 Rhogam for Rh-negative women at risk

of fetal blood exposure

Week 7

#255: Rhogam for Rh-negative women at risk of fetal blood exposure

Rh-negative pregnant females at risk of fetal blood exposure

should receive Rhogam

#255:Note

Risks for Fetal blood exposure

1. Abortion (or threatened abortion), or any vaginal bleeding during pregnancy

2. Blunt abdominal trauma (fall, MVC)

3. Ectopic Pregnancy

#255: Inclusion

Numerator: Patient had Rhogam order in ED

Denominator:1. Patients 14-50 years old2. Patient with documentation of

pregnancy in the medical record3. Patient at risk of fetal blood exposure4. Patient is Rh-negative

#255:Exclusion(ultrasound not required)

1. Patient refusal

2. Rhogam given in previous 12 weeks

3. Other documented reason such as “No Rhogam available, OB to arrange tomorrow.”

Best PracticesRather straight forward … Give Rhogam to appropriate patients.

Best practice:

1. “Patient with abdominal trauma and Rh-negative, Rhogam given.”2. Rhogam may be given without comment for appropriate patients, which would

meet the measure.3. “Patient received Rhogam 6 weeks ago, no Rhogam indicated.” (exclusion from

measure)