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CQUIN audit for prescription of antibiotics for urinary tract infections in an acute medical assessment unit

Urinary tract infections (UTI) are a common presentation in a medical assessment unit, and we wanted to check compliance with hospital guidelines for antibiotic prescribing in patients presenting to hospital with urinary tract infection. The guidelines are based on local organisms and sensitivities....

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Autores principales: Oppenheimer, Maylin, Rezwan, Nivin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: British Publishing Group 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4645900/
https://www.ncbi.nlm.nih.gov/pubmed/26734357
http://dx.doi.org/10.1136/bmjquality.u208446.w3374
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author Oppenheimer, Maylin
Rezwan, Nivin
author_facet Oppenheimer, Maylin
Rezwan, Nivin
author_sort Oppenheimer, Maylin
collection PubMed
description Urinary tract infections (UTI) are a common presentation in a medical assessment unit, and we wanted to check compliance with hospital guidelines for antibiotic prescribing in patients presenting to hospital with urinary tract infection. The guidelines are based on local organisms and sensitivities. A retrospective audit of 40 patient records with positive urine cultures from July to August 2013 showed that 20% of patients with culture confirmed UTI were not given antibiotics at all. Of those prescribed antibiotics, 25% were non-compliant with local policy, and nearly one in two patients received more than one antibiotic. Furthermore, stop dates were not stated on 77% of the drug charts and duration of treatment ranged from one to 11 days. Interventions were then introduced in the form of group teaching sessions, proactive checks by Trust pharmacists and widely distributed posters, and the same data sets collected for April to March 2014 to assess for efficacy of the interventions. On re-auditing, 35% patients were not prescribed any antibiotics. However, compliance with local policy was 100%, including 100% drug charts having a stop/review date stated. The overall duration of treatment now ranged from one to seven days, and fewer than one in four patients had more than one antibiotic. Our results showed that improvement was needed in antibiotic stewardship, in particular with regards to compliance with the local guidelines and documentation of prescription. We have demonstrated that it is possible to improve compliance through teaching, by displaying information prominently, and vigilance by the clinical team. The outcome of this is a decreased number and duration of antibiotics prescribed, which has benefits for the patients, the hospital, and the community as a whole. Further work would include interventions to improve the number of patients who are missing antibiotic prescriptions altogether.
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spelling pubmed-46459002016-01-05 CQUIN audit for prescription of antibiotics for urinary tract infections in an acute medical assessment unit Oppenheimer, Maylin Rezwan, Nivin BMJ Qual Improv Rep BMJ Quality Improvement Programme Urinary tract infections (UTI) are a common presentation in a medical assessment unit, and we wanted to check compliance with hospital guidelines for antibiotic prescribing in patients presenting to hospital with urinary tract infection. The guidelines are based on local organisms and sensitivities. A retrospective audit of 40 patient records with positive urine cultures from July to August 2013 showed that 20% of patients with culture confirmed UTI were not given antibiotics at all. Of those prescribed antibiotics, 25% were non-compliant with local policy, and nearly one in two patients received more than one antibiotic. Furthermore, stop dates were not stated on 77% of the drug charts and duration of treatment ranged from one to 11 days. Interventions were then introduced in the form of group teaching sessions, proactive checks by Trust pharmacists and widely distributed posters, and the same data sets collected for April to March 2014 to assess for efficacy of the interventions. On re-auditing, 35% patients were not prescribed any antibiotics. However, compliance with local policy was 100%, including 100% drug charts having a stop/review date stated. The overall duration of treatment now ranged from one to seven days, and fewer than one in four patients had more than one antibiotic. Our results showed that improvement was needed in antibiotic stewardship, in particular with regards to compliance with the local guidelines and documentation of prescription. We have demonstrated that it is possible to improve compliance through teaching, by displaying information prominently, and vigilance by the clinical team. The outcome of this is a decreased number and duration of antibiotics prescribed, which has benefits for the patients, the hospital, and the community as a whole. Further work would include interventions to improve the number of patients who are missing antibiotic prescriptions altogether. British Publishing Group 2015-05-20 /pmc/articles/PMC4645900/ /pubmed/26734357 http://dx.doi.org/10.1136/bmjquality.u208446.w3374 Text en © 2015, 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
Oppenheimer, Maylin
Rezwan, Nivin
CQUIN audit for prescription of antibiotics for urinary tract infections in an acute medical assessment unit
title CQUIN audit for prescription of antibiotics for urinary tract infections in an acute medical assessment unit
title_full CQUIN audit for prescription of antibiotics for urinary tract infections in an acute medical assessment unit
title_fullStr CQUIN audit for prescription of antibiotics for urinary tract infections in an acute medical assessment unit
title_full_unstemmed CQUIN audit for prescription of antibiotics for urinary tract infections in an acute medical assessment unit
title_short CQUIN audit for prescription of antibiotics for urinary tract infections in an acute medical assessment unit
title_sort cquin audit for prescription of antibiotics for urinary tract infections in an acute medical assessment unit
topic BMJ Quality Improvement Programme
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4645900/
https://www.ncbi.nlm.nih.gov/pubmed/26734357
http://dx.doi.org/10.1136/bmjquality.u208446.w3374
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