A Quality Improvement Project to Improve Knowledge of the Cost of Single-Use Endoscopy Devices in a University-Based Endoscopy Center

Abstract Aim The aim of this quality improvement project was to provide a solution to improve the confidence and skill of Oral and Maxillofacial Dental Core Trainees (DCTs) in venepuncture by attending phlebotomy training sessions. DCTs within the hospital where this project was undertaken are dentally qualified and are often not taught the principles of venepuncture during their undergraduate degree. Furthermore, they rarely gain hands-on experience to confidently apply these skills. Method Phlebotomy training sessions were held, each an hour and a half long and were completed within the first 4 weeks of the DCTs starting their job. A survey was completed by each of the DCTs prior to the training. The sessions consisted of a short introduction to phlebotomy and the different techniques, observing a phlebotomist taking blood, and then performing venepuncture on live patients attending the clinic who required blood investigations. The Vacutainer eclipse single needle was used with the single-use holder. Following the training, the DCTs completed a second survey. Results The mean confidence of the DCTs increased from 2.7 to 8.2 out of 10 following the phlebotomy training. 100% of the DCTs rated the quality of the workshop 10 out of 10, with 10 being excellent. The sessions had minimal disruption to the running of the phlebotomy and maxillofacial clinics. Conclusions This quality improvement project will have an overall benefit firstly to patients and also to the Health Board. The success of this programme lead to its permanent implementation within the curriculum for or each intake of new DCTs.

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Patient Safety and Efficacy of Metronidazole 1 g Intravenous Every 24 Hours

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.820 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S343-S343 ◽

Cited By ~ 1

Author(s):

Alpa Desai ◽

Steven Burdette

Keyword(s):

Quality Improvement ◽

Treatment Failure ◽

Quality Improvement Project ◽

Inclusion Criteria ◽

Bacterial Killing ◽

Improvement Project ◽

Once Daily ◽

Antibiotic Effect ◽

Anaerobic Infections ◽

The Cost

Abstract Background Metronidazole (MTZ) is an imidazole that is used to treat parasites and anaerobic infections. The traditional dose of 500 mg every 6 to 8 hours achieves adequate serum concentration to treat most anaerobic infections. MTZ has a concentration dependent bactericidal activity with a long half-life of 8 hours and also exhibits post-antibiotic effect. The literature lacks clinical data in regards to a once daily higher dose of IV MTZ. Methods A retrospective quality improvement project via electronic medical record review of 88 adults who received MTZ 1 gm IV daily at a single tertiary medical center, from April 2014 to October 2016. Inclusion criteria were patients >/=18 years who received MTZ 1 gm IV every daily for >/= 48 hours. Results Of the 88 patients who received 1 gm of MTZ, 66 met inclusion criteria. Mean age was 58 years (range 24 to 90 years). Indications for use are shown in Figure 1. Mean duration of therapy was 10 days (range 2 to 42 days). Twenty-nine (43.9%) received </= 6 days and 37 (56.1%) received >/= 7 days. Fourteen (21%) were discharged home on MTZ 1 gm IV daily for 4–6 weeks duration. One patient had a documented adverse reaction (severe nausea) while the other 65 tolerated well. No documented treatment failure was reported. Conclusion MTZ has been used in combination with other antimicrobial agents to treat polymicrobial infections. It is generally well tolerated when administered in dosages of <2gm per day. Pharmacodynamic studies have demonstrated activity for 12 to 24 hours after administration of 1 gm of MTZ. Our study showed no safety concerns with 1 gm daily dosing and no reported treatment failure. The limitation of our study includes lack of comparative cohort. The potential advantages of once daily dosing include optimized bacterial killing, minimization of drug administration, and reduction of the cost of antibiotics as well as the cost of administration. Our safety and quality improvement project support that MTZ 1 gm IV daily dose is potentially a safe, efficacious and cost effective alternative to three times dosing especially in hospitalized patients and may have role in OPAT. Disclosures All authors: No reported disclosures.

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