A Retrospective Study of Risk Factors for Redocumentation of Penicillin Allergy
Horbal A, Modi S, Sitarik A, Liu B, Kim H, and Zoratti E. A Retrospective Study of Risk Factors for Redocumentation of Penicillin Allergy. J Allergy Clin Immunol 2021; 147(2):AB119.
J Allergy Clin Immunol
Rationale: Electronic Medical Record (EMR) documentation of allergies is critical for patient safety and efficacious for appropriate treatment. Inaccuracies in documentation can cause serious problems and lead to increase in mortality and morbidity. Studies have addressed the detrimental effects of redocumentation of penicillin (PCN) though few have expanded on risk factors.
Methods: Patients who underwent inpatient or outpatient PCN skin testing between 3/1/13 and 10/31/19 at Henry Ford Health System were identified using EMR data. Existence and potential removal of PCN allergy in the EMR was extracted. Risk factors such as age, race, ethnicity, language, testing location, insurance, deprivation index, and dementia diagnosis were tested for association with PCN redocumentation using ANOVA, chi-squared tests, and Fisher’s exact tests.
Results: A total of 456 patients had a negative PCN skin test and had PCN allergy deleted from their EMR. Eleven of these patients were excluded because a reaction to PCN following skin testing was documented and PCN was therefore added back to their chart. Of the remaining 445, 81 (18.2%) had PCN redocumented without further explanation. Significant of reentry was recorded by 17 MDs, 30 RNs, 18 MAs, 4 CNPs. No statistically significant associations were identified with the examined risk factors, though patients who had an inpatient PCN skin test were slightly more likely to have PCN redocumentation (23.5% vs. 15.9%, p=0.072).
Conclusion: None of the examined risk factors were significantly associated with PCN redocumentation, though redocumentation was more likely to occur after inpatient PCN skin testing, and was primarily recorded by non-physicians.