Treatment of bacterial meningitiS

Measure Purpose: Ensure the rapid diagnosis and treatment of bacterial meningitis

The numerator: Patients >21 years of age where dexamethasone 10mg is given intravenously before or with the first dose of antibiotics in suspected acute bacterial meningitis

is divided by

The denominator: Patient with suspected acute bacterial meningitis

Exclusions are removed from the denominator for:

• History of hypersensitivity to corticosteroids
• Treated with oral or parenteral antibiotics in the previous 48 hours
• Recent history of head trauma, neurosurgery
• CSF shunt

Key Phrases

Key phrases you should document to meet the measure include:

• Suspected acute bacterial meningitis
• Dexamethasone 10mg given intravenously with first dose of antibiotics
• Dexamethasone 10mg given intravenously before first dose of antibiotics

Measure Calculation Example

Dr. Williams had 200 patients between January 1 and December 31 of the measurement year. 16 of them presented to the emergency department and 9 were admitted to the hospital. 15 of those 200 patients were suspected of having bacterial meningitis.

Of the 15 patients with suspected bacterial meningitis, 2 had been treated with oral or parenteral antibiotics in the previous 48 hours, and 1 had a hypersensitivity to corticosteroids. These three patients are excluded from being counted in the denominator.

Of the now 12 patients that still qualify for this measure, 5 patients had 10mg of dexamethasone given intravenously with the first dose of antibiotics, and 1 patient had 10mg of dexamethasone given intravenously before the first dose of antibiotics.

Quality of patient care = 6/(15-3). Dr. Williams has a score of 50% for this measure.