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The Champions League - Improving the quality of in-patient antibiotic prescription in Trauma and Orthopaedics

A Trust level audit demonstrated that the trauma and orthopaedic department did not reach its own standards in adhering to Trust antibiotic prescribing guidelines. Junior doctors are the main prescribers of antibiotics during inpatient stays. Local policy states that for all inpatients on antibiotic...

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Autores principales: Evans, Jonathan, Saxby, Clair, Armstrong, Alexander
Formato: Online Artículo Texto
Lenguaje:English
Publicado: British Publishing Group 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4645804/
https://www.ncbi.nlm.nih.gov/pubmed/26734266
http://dx.doi.org/10.1136/bmjquality.u201983.w1831
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author Evans, Jonathan
Saxby, Clair
Armstrong, Alexander
author_facet Evans, Jonathan
Saxby, Clair
Armstrong, Alexander
author_sort Evans, Jonathan
collection PubMed
description A Trust level audit demonstrated that the trauma and orthopaedic department did not reach its own standards in adhering to Trust antibiotic prescribing guidelines. Junior doctors are the main prescribers of antibiotics during inpatient stays. Local policy states that for all inpatients on antibiotics, the start date, duration, and indication for antibiotics must be documented on the drug card. Each patient drug card was reviewed by the department pharmacist and it was recorded whether the documentation was in line with Trust policy. A monthly league table, coined ‘The Champions League’, was created. It was published monthly and displayed in the doctors' office and other clinical areas to highlight which doctors had or had not adhered to the prescribing guidelines. In August 2012 the monthly audit for the trauma and orthopaedic department included 74 patients. The total number of antibiotic courses prescribed was 28; of these courses only 15 (53.5%) had an indication documented and 15 (53.5%) had a review/stop date documented. In December 2012, after two published league tables, 61 patients were reviewed. A total of 19 antibiotic courses were prescribed; 18 (94.7%) had the indication documented and 16 (84.2%) had the review/stop date documented. The standards of prescribing improved within the department and good prescribing practice became ingrained into each doctor's practice. The league table proved to be a novel tool that helped to raise the profile of antibiotic prescribing and change doctor prescribing habits. It created a competitive spirit within the department which improved morale. Doctors responded positively to feedback if they were not achieving the desirable standards, and enjoyed the challenge of improving the standard of prescribing.
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spelling pubmed-46458042016-01-05 The Champions League - Improving the quality of in-patient antibiotic prescription in Trauma and Orthopaedics Evans, Jonathan Saxby, Clair Armstrong, Alexander BMJ Qual Improv Rep BMJ Quality Improvement Programme A Trust level audit demonstrated that the trauma and orthopaedic department did not reach its own standards in adhering to Trust antibiotic prescribing guidelines. Junior doctors are the main prescribers of antibiotics during inpatient stays. Local policy states that for all inpatients on antibiotics, the start date, duration, and indication for antibiotics must be documented on the drug card. Each patient drug card was reviewed by the department pharmacist and it was recorded whether the documentation was in line with Trust policy. A monthly league table, coined ‘The Champions League’, was created. It was published monthly and displayed in the doctors' office and other clinical areas to highlight which doctors had or had not adhered to the prescribing guidelines. In August 2012 the monthly audit for the trauma and orthopaedic department included 74 patients. The total number of antibiotic courses prescribed was 28; of these courses only 15 (53.5%) had an indication documented and 15 (53.5%) had a review/stop date documented. In December 2012, after two published league tables, 61 patients were reviewed. A total of 19 antibiotic courses were prescribed; 18 (94.7%) had the indication documented and 16 (84.2%) had the review/stop date documented. The standards of prescribing improved within the department and good prescribing practice became ingrained into each doctor's practice. The league table proved to be a novel tool that helped to raise the profile of antibiotic prescribing and change doctor prescribing habits. It created a competitive spirit within the department which improved morale. Doctors responded positively to feedback if they were not achieving the desirable standards, and enjoyed the challenge of improving the standard of prescribing. British Publishing Group 2014-03-25 /pmc/articles/PMC4645804/ /pubmed/26734266 http://dx.doi.org/10.1136/bmjquality.u201983.w1831 Text en © 2014, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/http://creativecommons.org/licenses/by-nc/2.0/legalcode
spellingShingle BMJ Quality Improvement Programme
Evans, Jonathan
Saxby, Clair
Armstrong, Alexander
The Champions League - Improving the quality of in-patient antibiotic prescription in Trauma and Orthopaedics
title The Champions League - Improving the quality of in-patient antibiotic prescription in Trauma and Orthopaedics
title_full The Champions League - Improving the quality of in-patient antibiotic prescription in Trauma and Orthopaedics
title_fullStr The Champions League - Improving the quality of in-patient antibiotic prescription in Trauma and Orthopaedics
title_full_unstemmed The Champions League - Improving the quality of in-patient antibiotic prescription in Trauma and Orthopaedics
title_short The Champions League - Improving the quality of in-patient antibiotic prescription in Trauma and Orthopaedics
title_sort champions league - improving the quality of in-patient antibiotic prescription in trauma and orthopaedics
topic BMJ Quality Improvement Programme
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4645804/
https://www.ncbi.nlm.nih.gov/pubmed/26734266
http://dx.doi.org/10.1136/bmjquality.u201983.w1831
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