Promoting non-medical prescribing practice using targeted education and prescribing tools in an MSK assessment service (MSK CATS)

Physiotherapy ◽  
2021 ◽  
Vol 113 ◽  
pp. e187-e188
Author(s):  
L. Ronan ◽  
P. Regan
Keyword(s):  
Prescribing Practice

scholarly journals Assessment of implementation of antibiotic stewardship program in surgical prophylaxis at a secondary care hospital in Ras Al Khaimah, United Arab Emirates

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hessa Saleh Alshehhi ◽  
Areeg Anwer Ali ◽  
Duaa Salem Jawhar ◽  
Essam Mahran Aly ◽  
Srinivas Swamy ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
United Arab Emirates ◽  
Antibiotic Stewardship ◽  
Secondary Care ◽  
Care Hospital ◽  
Surgical Prophylaxis ◽  
Patient Profile ◽  
Stewardship Program ◽  
Prescribing Practice ◽  
Surgical Antibiotic Prophylaxis

AbstractAntibiotic overuse is a major factor for causing antibiotic resistance globally. However, only few studies reported the implementation and evaluation of antimicrobial stewardship programs in Gulf Cooperation Council. This study was conducted within 8-months periods to evaluate the effect of the newly implemented antibiotic stewardship program on improving the prescribing practice of surgical antibiotic prophylaxis in a secondary care hospital in the United Arab Emirates by releasing local hospital guidelines. The data of 493 in patients were documented in the predesigned patient profile form and the prescribing practice of surgical antibiotic prophylaxis for clean and clean-contaminant surgical procedures was compared and analyzed two months’ prior (period A) and post (period B) the implementation of antibiotic stewardship program. The 347 patient’s data (PD) were analyzed during period A and 146 PD during period B. The prescription of piperacillin/tazobactam was decreased from 2.4% from all surgical prophylaxis antibiotic orders in period A to 0% in period B. The appropriateness of the antibiotic therapy was found to differ non significantly for the selection of prophylactic antibiotic (p = 0.552) and for the timing of first dose administration (p = 0.061) between A and B periods. The total compliance was decreased non significantly (P = 0.08) from 45.3 to 40.2%. Overall, the guidelines have improved the prescribing practice of antibiotics prior to surgery. However, further improvement can be achieved by initiating educational intervention via cyclic auditing strategy.

scholarly journals Development of an explicit tool assessing potentially inappropriate medication use in Hong Kong elder patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Huanyu Zhang ◽  
Eliza LY Wong ◽  
Eng-kiong Yeoh ◽  
Bosco HM Ma
Keyword(s):  
Hong Kong ◽  
Inappropriate Medication ◽  
Delphi Process ◽  
Potentially Inappropriate Medication ◽  
Medical Conditions ◽  
Modified Delphi ◽  
Adverse Health Outcomes ◽  
Elder Patients ◽  
Prescribing Quality ◽  
Prescribing Practice

Abstract Background Potentially inappropriate medication (PIM) use has adverse effects on health, particularly in elder patients. Various country-specific explicit criteria have been developed to measure the appropriateness of prescribing worldwide. However, it is difficult to apply the criteria developed from other regions to measure and guide the local prescribing practice in Hong Kong. This study aims to develop a Hong Kong-specific PIM assessing tool from previously published criteria and validate this tool using the modified Delphi method. Methods A disease-oriented Hong Kong-specific preliminary PIM list was developed based on nine sets of reference criteria selected from a literature review. Any medication or medication class appeared in at least two sets of the reference criteria as well as its related medical conditions were selected as PIM candidates. After examining the availability of PIM candidates by the Hong Kong Hospital Authority drug formulary, the Hong Kong-specific preliminary PIM list was validated by a two-round of modified Delphi process. Eight experts from different specialties were invited to rate the degree of inappropriateness of each PIM candidate using a five-point Likert scale. The experts were also encouraged to propose therapeutic alternatives and new PIM candidates not covered by the preliminary PIM list. The PIM candidates that the expert panel didn’t reach consensus on were excluded from the final Hong Kong-specific PIM list. Results After two rounds of the Delphi process, eight PIM candidates remained questionable and thus were excluded from the PIM list. The final Hong Kong-specific PIM list included a total of 164 statements applicable to older adults aged 65 years or above, among which 77 were under PIMs independent of diagnoses, and 87 were under PIMs considering specific medical conditions. Conclusions The Hong Kong-specific PIM list can be used as a quality measure and an educational tool to improve the local prescribing quality. Further studies should validate its association with adverse health outcomes in clinical and research settings.

scholarly journals P-16 Audit of adherence to prescribing standards as a means of improving prescribing practice on drug charts in a hospice in-patient unit

2017 ◽  
Vol 7 (Suppl 1) ◽  
pp. A6.1-A6
Author(s):  
Annelise Matthews ◽  
Nick Green ◽  
Sunil Hathi ◽  
Hamna Jaffar ◽  
Arjun Kingdon ◽  
...  
Keyword(s):  
Prescribing Practice ◽  
P 16

115 An Audit on Dexamethasone Prescribing Practice on Surgically Managed Metastatic Spinal Cord Compression Patients in the Manchester Centre for Clinical Neurosciences: Lessons Learned in Closing the Loop

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
R Laurente ◽  
R Mohammed ◽  
M Elmalky
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Lessons Learned ◽  
Metastatic Spinal Cord Compression ◽  
Loading Dose ◽  
The Past ◽  
Prescribing Practice ◽  
Closing The Loop ◽  
Almost All

Abstract Metastatic Spinal Cord Compression is a surgical emergency owing to its propensity to cause significant morbidity and mortality. Dexamethasone is prescribed to reduce oedema and promote vascular membrane stabilization. The is done so until a more definitive management has been performed. This is a retrospective study evaluating the steroid-prescribing practice for MSCC patients in 2018 at a tertiary spinal unit in Greater Manchester. Thirty-three patients who underwent stabilisation were evaluated in terms of both steroid prescribing and weaning practices. Standards used against for both were the NICE guidelines and the Edinburgh/Christie’s guidelines. Of the 33 patients evaluated, only 1 patient received the correct loading dose of 16mg, whilst 27 went straight to being given 8mg BD. 5 did not receive dexamethasone at all. In terms of discontinuation/weaning, 26 were weaned accordingly and 2 were not weaned to continue as adjuvant treatment. Dexamethasone prescribing practises has since improved over the past two years. 93% of the patients have been correctly weaned as compared to 38% in the past. In terms of prescription, much needs to be done as almost all the patients evaluated did not get the correct loading dose despite receiving the appropriate maintenance.

Prescribing practice: an overview of the principles

2021 ◽  
Vol 30 (17) ◽  
pp. 1016-1022
Author(s):  
Aby Mitchell ◽  
Reuben Pearce
Keyword(s):  
Hospital Admissions ◽  
Healthcare Services ◽  
Valuable Resource ◽  
Long Term Conditions ◽  
Legal Principles ◽  
Nurse Prescribing ◽  
Prescribing Practice ◽  
Hospital Stays

Nurse prescribing has become a well-established aspect of advanced clinical practice working alongside key NHS principles and drivers to address the increasing complexities in patient care and the demands on the health service. Prescribing practice is governed by ethical and legal principles to ensure a holistic patient-centred approach. It has been recognised as a valuable resource that could effectively transform healthcare services to reduce hospital admissions and long hospital stays and improve the quality of life for patients with long-term conditions and multiple comorbidities. This article will provide an overview of prescribing practice.

Anaphylaxis To Pantoprazole: A Case Report And Prerequisite For Vigilant Prescribing Practises For Proton Pump Inhibitors

2021 ◽  
Vol 16 ◽  
Author(s):  
Jerin James ◽  
Jamuna Rani ◽  
Sathyanarayanan V ◽  
Syed Hussain Fayaz ◽  
Althab Begum
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
The Elderly ◽  
Acid Synthesis ◽  
Synthesis Inhibitor ◽  
Case Summary ◽  
The World ◽  
Prescribing Practice ◽  
Physician Awareness ◽  
Gastrointestinal Complaints

Background: Pantoprazole is a Proton Pump Inhibitor, commonly used by clinicians all over the world as gastric acid synthesis inhibitor for a wide variety of gastrointestinal disorders and the efficacy and the safety of the drug is unsurmountable. PPIs are being prescribed nowadays for unapproved indications as well and it is one among the widely used medications in the world. Consequently, adverse events are commonly reported nowadays with proton pump inhibitors and it is essential to improve the physician awareness regarding judicious prescribing practice. Objective: To report a case of anaphylaxis to pantoprazole which occurred in a patient admitted with gastrointestinal complaints. Case summary: Within few minutes of intravenous infusion of pantoprazole, a 75-year-old female developed anaphylaxis. The adverse drug reaction was promptly diagnosed, and patient was resuscitated. Conclusion: It is imperative that clinicians should be aware of this adverse effect that might occur with pantoprazole and hence be more cautious while prescribing the drug, especially in the elderly.

scholarly journals Variation between services in polypharmacy and combined high dose of antipsychotic drugs prescribed for in-patients

2002 ◽  
Vol 26 (11) ◽  
pp. 418-420 ◽  
Author(s):  
Maria Harrington ◽  
Paul Lelliott ◽  
Carol Paton ◽  
Maria Konsolaki ◽  
Tom Sensky ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Antipsychotic Drugs ◽  
Service Level ◽  
Case Mix ◽  
Clinical Implications ◽  
High Dose ◽  
Prescribing Practice ◽  
Acute Psychiatric Wards ◽  
High Doses

Aims and MethodA 1-day census provided an opportunity to examine the variation between 44 mental health services in the frequency of prescribing high doses and polypharmacy of antipsychotic drugs to in-patients on acute psychiatric wards.ResultsThe proportion of patients prescribed a high dose ranged 0–50% and simultaneous use of more than one antipsychotic drug ranged 12–71%. A number of case-mix variables explained 26% and 40%, respectively, of the variance between services on these two indicators of prescribing practice.Clinical ImplicationsServices with high rates of prescription of high dose or polypharmacy might consider a review of clinical practice and of service-level factors that might affect prescribing.

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