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Omitted doses as an unintended consequence of a hospital restricted antibacterial system: a retrospective observational study
OBJECTIVES: The objective of this study was to determine the frequency of omitted doses of antibacterial agents and explore a number of risk factors, including the effect of a restricted antibacterial system. METHODS: Antibacterial data were extracted from a hospital electronic prescribing and medic...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4652685/ https://www.ncbi.nlm.nih.gov/pubmed/26316382 http://dx.doi.org/10.1093/jac/dkv264 |
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author | Powell, Neil Franklin, Bryony Dean Jacklin, Ann Wilcock, Mike |
author_facet | Powell, Neil Franklin, Bryony Dean Jacklin, Ann Wilcock, Mike |
author_sort | Powell, Neil |
collection | PubMed |
description | OBJECTIVES: The objective of this study was to determine the frequency of omitted doses of antibacterial agents and explore a number of risk factors, including the effect of a restricted antibacterial system. METHODS: Antibacterial data were extracted from a hospital electronic prescribing and medication administration system for the period 1 January to 30 April 2014. Percentage dose omission rates were calculated. Omission rates for the first dose of antibacterial courses were analysed using logistic regression to identify any correlation between first dose omission rates and potential risk factors, including the antibacterials' restriction status and whether or not they were ward stock. RESULTS: The study included 90 761 antibacterial doses. Of these, 6535 (7.2%) were documented as having been omitted; omission of 847 (0.9% of 90 761) was due to medication being unavailable. Non-restricted, ward stock antibacterials had the lowest frequency of omission, with 6.2% (271 of 4391) first doses omitted. The prevalence was 10.4% (27 of 260) for restricted, ward-stock antibacterials (OR = 1.6, 95% CI = 1.0–2.4, P = 0.027) and 15.5% (53 of 341) for non-restricted, non-ward stock antibacterials (OR = 2.7, 95% CI = 2.0–3.7, P < 0.001). Restricted, non-ward stock antibacterials had the highest frequency (30.7%, 71 of 231; OR = 6.2, 95% CI = 4.5–8.4, P < 0.001). CONCLUSIONS: Antibacterials not stocked in clinical areas were significantly more likely to be omitted. The prevalence of omitted doses increased further if the antibiotic was also restricted. To achieve safe, effective antimicrobial use, a balance is needed between promoting antimicrobial stewardship and preventing unintended omitted doses. |
format | Online Article Text |
id | pubmed-4652685 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-46526852015-11-25 Omitted doses as an unintended consequence of a hospital restricted antibacterial system: a retrospective observational study Powell, Neil Franklin, Bryony Dean Jacklin, Ann Wilcock, Mike J Antimicrob Chemother Original Research OBJECTIVES: The objective of this study was to determine the frequency of omitted doses of antibacterial agents and explore a number of risk factors, including the effect of a restricted antibacterial system. METHODS: Antibacterial data were extracted from a hospital electronic prescribing and medication administration system for the period 1 January to 30 April 2014. Percentage dose omission rates were calculated. Omission rates for the first dose of antibacterial courses were analysed using logistic regression to identify any correlation between first dose omission rates and potential risk factors, including the antibacterials' restriction status and whether or not they were ward stock. RESULTS: The study included 90 761 antibacterial doses. Of these, 6535 (7.2%) were documented as having been omitted; omission of 847 (0.9% of 90 761) was due to medication being unavailable. Non-restricted, ward stock antibacterials had the lowest frequency of omission, with 6.2% (271 of 4391) first doses omitted. The prevalence was 10.4% (27 of 260) for restricted, ward-stock antibacterials (OR = 1.6, 95% CI = 1.0–2.4, P = 0.027) and 15.5% (53 of 341) for non-restricted, non-ward stock antibacterials (OR = 2.7, 95% CI = 2.0–3.7, P < 0.001). Restricted, non-ward stock antibacterials had the highest frequency (30.7%, 71 of 231; OR = 6.2, 95% CI = 4.5–8.4, P < 0.001). CONCLUSIONS: Antibacterials not stocked in clinical areas were significantly more likely to be omitted. The prevalence of omitted doses increased further if the antibiotic was also restricted. To achieve safe, effective antimicrobial use, a balance is needed between promoting antimicrobial stewardship and preventing unintended omitted doses. Oxford University Press 2015-12 2015-08-27 /pmc/articles/PMC4652685/ /pubmed/26316382 http://dx.doi.org/10.1093/jac/dkv264 Text en © The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Original Research Powell, Neil Franklin, Bryony Dean Jacklin, Ann Wilcock, Mike Omitted doses as an unintended consequence of a hospital restricted antibacterial system: a retrospective observational study |
title | Omitted doses as an unintended consequence of a hospital restricted antibacterial system: a retrospective observational study |
title_full | Omitted doses as an unintended consequence of a hospital restricted antibacterial system: a retrospective observational study |
title_fullStr | Omitted doses as an unintended consequence of a hospital restricted antibacterial system: a retrospective observational study |
title_full_unstemmed | Omitted doses as an unintended consequence of a hospital restricted antibacterial system: a retrospective observational study |
title_short | Omitted doses as an unintended consequence of a hospital restricted antibacterial system: a retrospective observational study |
title_sort | omitted doses as an unintended consequence of a hospital restricted antibacterial system: a retrospective observational study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4652685/ https://www.ncbi.nlm.nih.gov/pubmed/26316382 http://dx.doi.org/10.1093/jac/dkv264 |
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