683 A Quality Improvement Project (QIP) To Increase Compliance with Peri-Operative Antibiotic Guidelines in Colorectal Surgery (CS)

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
H Carter ◽  
C Wood
Keyword(s):  
Antibiotic Prophylaxis ◽  
Antibiotic Prescription ◽  
Prescription Data ◽  
Improvement Project ◽  
Guideline Compliance ◽  
Operating Theatres ◽  
Improve Compliance ◽  
Abdominal Infections ◽  
Prophylaxis Guideline ◽  
Local Guideline

Abstract Introduction In CS, the correct use of antibiotics is important in order to reduce the risk of surgical site and intra-abdominal infections, whilst balancing risks from overuse of antibiotics. The Commissioning for Quality and Improvement (CQUIN) of 2019/20 identified that antibiotic prophylaxis guideline compliance could be enhanced in CS. This QIP aimed to improve local CS antibiotic prophylaxis and extension guideline compliance. Method In December 2019, an educational session was held to highlight the details of the local guideline and prescribing discrepancies. A3 posters of the guideline were created for accessible reference in operating theatres. Perioperative antibiotic prescription data from all colorectal elective cases in January 2020 were extracted and analysed using descriptive methods. Results Out of 93 cases in the sample, 70 (75.3%) were compliant with the prophylaxis guideline. However, metronidazole was commonly used in perianal surgery, which is not recommended. 13 cases required extension of the antibiotic course, of which seven were compliant (53.8%). The main issues included: use of agents and course durations which were not indicated; and a lack of antibiotic switch after a pause in therapy. Conclusions To further improve compliance with antibiotic guidelines, targeting historic practice, increasing awareness, and making systemic change is required for the next cycle.

scholarly journals The prescription pattern and awareness about antibiotic prophylaxis and resistance among a group of Egyptian pediatric and general dentists: a cross sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mariam Mohsen Aly ◽  
Marwa Aly Elchaghaby
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Prophylaxis ◽  
Antibiotic Prescription ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Major Public Health Problem ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Validated Questionnaire ◽  
General Dentists

Abstract Background The use of antibiotics in dentistry as prophylaxis and treatment is frequent. Their misuse has led to a major public health problem globally known as antibiotic resistance. This study aimed to assess the pattern of antibiotic prescription and its prophylactic use for systemic conditions. Besides, this study evaluated the awareness and adherence to antibiotic prescription guidelines and antibiotic prophylaxis guidelines along with awareness of antibiotic resistance across pediatric and general dentists. Methods An overall of 378 pediatric and general dentists meeting the required eligibility criteria, fulfilled a pre-designed validated questionnaire. Data were collected, tabulated, and statistically analyzed. Results A significant statistical difference was found among the pediatric and general dentists regarding antibiotics prescription for most of the oral conditions where Amoxicillin with clavulanic acid was the most frequently prescribed antibiotic among the two groups (53% pediatric dentist and 52% general dentist). The majority of pediatric and general dentists, on the other hand, were aware of antibiotic resistance and prescribing recommendations. Conclusions The present study showed a tendency to overprescribe and overuse antibiotics in certain dental conditions among the participants. The vast majority of dentists, especially general dentists do not have adherence to professional guidelines for antibiotics prescription in children despite their awareness of antibiotic resistance and prescription guidelines.

A tale of 2 hospitals: A staggered cohort study of targeted interventions to improve compliance with antibiotic prophylaxis guidelines

Surgery ◽  
2010 ◽  
Vol 148 (2) ◽  
pp. 255-262 ◽  
Author(s):  
Lillian S. Kao ◽  
Debbie F. Lew ◽  
Peter D. Doyle ◽  
Matthew M. Carrick ◽  
Victoria S. Jordan ◽  
...  
Keyword(s):  
Cohort Study ◽  
Antibiotic Prophylaxis ◽  
Targeted Interventions ◽  
Improve Compliance

scholarly journals Protecting patients from infection: Improving topical prophylaxis compliance on surgical wards

2019 ◽  
Vol 21 (2) ◽  
pp. 47-51
Author(s):  
Holly Slyne ◽  
Natalie Clews ◽  
Sid Beech ◽  
Elizabeth Smilie
Keyword(s):  
Quality Improvement ◽  
Infection Prevention ◽  
Communication Strategies ◽  
District General Hospital ◽  
Site Infection ◽  
Improvement Project ◽  
Medication Prescription ◽  
Improvement Plan ◽  
Number Of Patients ◽  
Improve Compliance

Background: At a medium-sized district general hospital in the heart of England, it was identified that compliance to the administration of topical prophylaxis on three general surgery wards had reduced to 23%, following implementation of an electronic medication prescription record. Therefore, a quality improvement project was commenced to improve this compliance to protect patients from meticillin-resistant Staphylococcus aureus (MRSA) colonisation and associated bacteraemia. Aim: To improve compliance of topical prophylaxis administration on three surgical wards to protect patients from infection. Method: Quality improvement plan – do – study – act (PDSA) cycles evaluated the effectiveness of four different strategies from baseline data which was 23% compliant in December 2016. These included teaching and communication strategies, prompts in medical notes, discontinuation of Mupirocin 2% nasal ointment as part of the topical prophylaxis regime and discontinuation of the topical wash lotion from requiring a prescription. Results: The compliance of prophylaxis administration increased consistently throughout from 23% in December 2016 to 92% in March 2018. Consequently, the number of patients that developed a MRSA colonisation on the three wards reduced by 54%, from 13 in the 12 months before the study to six in the 12 months after the study. Discussion: This study led to a change in the Trust MRSA Policy to better protect patients from infection, particularly surgical site infection and MRSA bacteraemia. It suggests that quality improvement methodology has a place in infection prevention practice.

scholarly journals Ward round template: enhancing patient safety on ward rounds

2018 ◽  
Vol 7 (2) ◽  
pp. e000170 ◽  
Author(s):  
Niall Gilliland ◽  
Natalie Catherwood ◽  
Shaouyn Chen ◽  
Peter Browne ◽  
Jacob Wilson ◽  
...  
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Antibiotic Stewardship ◽  
Ward Round ◽  
Early Warning Score ◽  
Improvement Project ◽  
Inpatient Ward ◽  
Improve Compliance ◽  
Safety Parameters ◽  
Ward Rounds

Introduction and aimsConcerns had been raised at clinical governance regarding the safety of our inpatient ward rounds with particular reference to: documentation of clinical observations and National Early Warning Score (NEWS), compliance with Trust guidance for venous thromboembolism (VTE) risk assessment, antibiotic stewardship, palliative care and treatment escalation plans (TEP). This quality improvement project was conceived to ensure these parameters were considered and documented during the ward round, thereby improving patient care and safety. These parameters were based on Trust patient safety guidance and CQUIN targets.MethodThe quality improvement technique of plan–do–study–act (PDSA) was used in this project. We retrospectively reviewed ward round entries to record baseline measurements, based on the above described parameters, prior to making any changes. Following this, the change applied was the introduction of a ward round template to include the highlighted important baseline parameters. Monthly PDSA cycles are performed, and baseline measurements are re-examined, then relevant changes were made to the ward round template.Summary of resultsDocumentation of baseline measurements was poor prior to introduction of the ward round template; this improved significantly following introduction of a standardised ward round template. Following three cycles, documentation of VTE risk assessments increased from 14% to 92%. Antibiotic stewardship documentation went from 0% to 100%. Use of the TEP form went from 29% to 78%.ConclusionsFollowing introduction of the ward round template, compliance improved significantly in all safety parameters. Important safety measures being discussed on ward rounds will lead to enhanced patient safety and will improve compliance to Trust guidance and comissioning for quality and innovation (CQUIN) targets. Ongoing change implementation will focus on improving compliance with usage of the template on all urology ward rounds.

Barriers to receipt of novel oral oncolytics: A single-institution quality improvement investigation

2019 ◽  
Vol 26 (2) ◽  
pp. 279-285
Author(s):  
Ann A Wang ◽  
Christopher Tapia ◽  
Yasin Bhanji ◽  
Christopher Campbell ◽  
Daniel Larsen ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Care Center ◽  
Tertiary Care ◽  
Standard Of Care ◽  
Wait Times ◽  
Prescription Data ◽  
Electronic Prescription ◽  
Improvement Project ◽  
Pharmacy Claims ◽  
Oral Oncolytics

Introduction Novel oral oncolytic agents have become the standard of care and first-line therapies for many malignancies. However, issues impacting access to these drugs are not well explored. As part of a quality improvement project in a large tertiary academic institution, we aim to identify potential barriers that delay treatment for patients who are prescribed novel oral oncolytics. Methods This was a retrospective review of adults who were newly prescribed a novel oral oncolytic for Food and Drug Administration-approved indications at a single tertiary care center. Patients were identified via electronic prescription data (e-Scribe). Demographics, insurance information, and prescription dates were extracted from the electronic medical record and pharmacy claims data. Statistical analyses were performed to determine whether time-to-receipt was associated with insurance category, pharmacy transfers, cost assistance, and drug prescribed. Results Of the 270 successfully filled prescriptions, the mean time-to-receipt was 7.3 ± 10.3 days (range: 0–109 days). Patients with Medicare experienced longer time-to-receipt (9.1 ± 13.1 days) compared to patients with commercial insurance (4.4 ± 3.3). Uninsured patients experienced the longest time-to-receipt (15.7 ± 7.8 days) overall. Pharmacy transfers and cost assistance programs were also significantly associated with longer time-to-receipt. Ten prescriptions remained unfilled 90 days after the study period and were considered abandoned. Conclusion Insurance has a significant effect on the time-to-receipt of newly prescribed novel oral oncolytics. Pharmacy transfers and applying for cost assistance are also associated with longer wait times for patients. Our retrospective analysis identifies areas of improvement for future interventions to reduce wait times for patients receiving novel oral oncolytics.

Guideline-Concordant Versus Discordant Antimicrobial Therapy in Patients With Community-Onset Complicated Intra-abdominal Infections

2016 ◽  
Vol 37 (7) ◽  
pp. 855-858 ◽  
Author(s):  
Lori L. Huang ◽  
Trevor C. Van Schooneveld ◽  
Robert D. Huang ◽  
Keith M. Olsen ◽  
Mark E. Rupp ◽  
...  
Keyword(s):  
Antimicrobial Therapy ◽  
Empiric Therapy ◽  
Infect Control Hosp ◽  
Active Therapy ◽  
Abdominal Infection ◽  
Guideline Compliance ◽  
Improved Outcomes ◽  
Intra Abdominal Infection ◽  
Abdominal Infections ◽  
Community Onset

Overall IDSA/SIS intra-abdominal infection guideline compliance was not associated with improved outcomes; however, there was a longer time to active therapy (P=.024) and higher mortality (P=.077) if empiric therapy was too narrow per guidelines. These findings support the need for the implementation of customized institutional guidelines adapted from the IDSA/SIS guidelines.Infect Control Hosp Epidemiol 2016;37:855–858

scholarly journals Antibiotic use for typhoid in India: Estimation from private sector prescription data during 2013-15

2021 ◽  
Author(s):  
Shaffi Fazaludeen Koya ◽  
Habib Hasan Farooqui ◽  
Aashna Mehta ◽  
Sakthivel Selvaraj ◽  
Sandro Galea
Keyword(s):  
Private Sector ◽  
Disease Surveillance ◽  
Primary Care Physicians ◽  
Antibiotic Prescription ◽  
Antibiotic Use ◽  
Population Based ◽  
Prescription Data ◽  
Adult Age ◽  
Disease Surveillance System ◽  
Prescription Rates

Background India's typhoid burden estimates are based on a limited number of population-based studies and data from a grossly incomplete disease surveillance system. In this study, we estimated the total and sex-and age-specific antibiotic prescription rates for typhoid. Methods We used systematic antibiotic prescription by private sector primary care physicians in India. We categorized antibiotics using the WHO classification system and calculated the prescription for various classes of antibiotics. Results We analyzed 671 million prescriptions for the three-year period (2013-2015), of which an average of 8.98 million antibiotic prescriptions per year was for typhoid, accounting for 714 prescriptions per 100,000 population. Combination antibiotics are the preferred choice of prescribers in the adult age group, while cephalosporins are the preferred choice in children and young age. The prescription rate decreased from 792/100,000 in 2013 to 635 in 2015. Conclusion We report a higher rate of antibiotic prescription for typhoid using prescription data, indicating a higher disease burden than previously estimated. Quinolones are still widely used in monotherapy, and children less than 10 years account for more than a million cases annually, which calls for a routine vaccination program.

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