Maintaining and developing prescribing practice: Non-medical prescribing by health visitors in 2015

Obstetrics (a branch of medicine focusing on childbirth and midwifery), gynaecology (a field of medicine specific to women and girls with a particular focus on the reproductive system), and neonatology (a subspecialty of paediatrics focused on the care of newborn infants, especially those who are premature) cover the whole span of pre-conception, pregnancy, childbirth, and the postpartum period for both mothers and babies. The topics covered by these disciplines include family planning, reproductive medicine, menopausal and geriatric (older adult) gynaecology, maternal medicine, and female urology. Because of the breadth of these disciplines, care teams involve hospital clinicians, surgeons, family doctors, nurses, midwives, doulas, and health visitors, among others....

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Health visitors urged to promote flu vaccine

Journal of Health Visiting ◽

10.12968/johv.2019.7.12.561 ◽

2019 ◽

Vol 7 (12) ◽

pp. 561-561

Author(s):

Polly Moffat

Keyword(s):

Health Visitors ◽

Flu Vaccine

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

Scientific Reports ◽

10.1038/s41598-020-80219-y ◽

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.

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

BMC Geriatrics ◽

10.1186/s12877-021-02024-0 ◽

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.

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