Skip to main content

Advertisement

SpringerLink
Log in

The effect of re-audit and education on antibiotic prescribing practice at Causeway Hospital, Northern Ireland

  • Original Article
  • Published:
Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Background

Antimicrobial resistance is a growing global problem. There has been increasing emphasis on promoting antimicrobial stewardship. Accurate completion of antibiotic prescriptions, such as documentation of clinical indication and a stop/review date, helps promote antimicrobial stewardship.

Aims

To investigate the impact of educational interventions on the completeness of antibiotic prescriptions at Causeway Hospital surgical unit.

Methods

Inpatient drug prescription charts were audited to monitor the completeness of antibiotic prescriptions on the surgical unit. Two educational interventions were implemented, with a subsequent prospective re-audit carried out.

Results

The completion of (1) “Stop date/Review date”, (2) “What infection are you treating?”, (3) “Cultures sent?”, (4) “Printed name”, (5) “Professional number”, and (6) “Bleep number” fields within the inpatient drug charts increased noticeably in the re-audit. A paired t test, comparing all of the initial audit completion proportions with the re-audit completion proportions, demonstrated a statistically significant improvement (p < 0.05).

Conclusions

Educational interventions led to an improvement in the completeness of antibiotic prescriptions. This highlights the important role that continued audit and education play in the promotion of antimicrobial stewardship.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Owens RC Jr (2008) Antimicrobial stewardship: concepts and strategies in the 21st century. Diagn Microbiol Infect Dis 61(1):110–128. https://doi.org/10.1016/j.diagmicrobio.2008.02.012

    Article  PubMed  Google Scholar 

  2. Sartelli M, Catena F, di Saverio S, Ansaloni L, Coccolini F, Tranà C, Kirkby-Bott J (2015) The challenge of antimicrobial resistance in managing intra-abdominal infections. Surg Infect 16(3):213–220. https://doi.org/10.1089/sur.2013.262

    Article  Google Scholar 

  3. Department of Health. (2017) Ireland’s National Action Plan on Antimicrobial Resistance 2017-2020. https://health.gov.ie/wp-content/uploads/2017/10/iNAP_web-1.pdf Accessed 18 December 2018

  4. Hospital Antimicrobial Stewardship Working Group. (2017) Recommendations for Implementation of Antimicrobial Stewardship Restrictive Interventions in Acute Hospitals in Ireland. https://www.hse.ie/eng/about/who/qid/nationalsafetyprogrammes/hcaiamr/recommendations-for-restricted-antimicrobials%202017.pdf Accessed 18 December 2018

  5. Public Health Agency (2017) Surveillance of Antimicrobial Use and Resistance in Northern Ireland, Annual Report, 2017. http://www.publichealth.hscni.net/sites/default/files/AMR_annual_report_final_1.pdf Accessed 18 December 2018

  6. National Institute for Health and Care Excellence (NICE). (2015) Antimicrobial stewardship: systems and processes for effective antimicrobial medicine use. https://www.nice.org.uk/guidance/ng15/resources/antimicrobial-stewardship-systems-and-processes-for-effective-antimicrobialmedicine-use-1837273110469 Accessed 18 December 2018

  7. Johnson AP, Ashiru-Oredope D, Beech E (2015) Antibiotic stewardship initiatives as part of the UK 5-year antimicrobial resistance strategy. Antibiotics (Basel) 4(4):467–479. https://doi.org/10.3390/antibiotics4040467

    Article  CAS  Google Scholar 

  8. Pollack LA, Plachouras D, Gruhler H et al. (2015) Summary the modified Delphi process for common structure and process indicators for hospital antimicrobial stewardship programs. https://www.cdc.gov/drugresistance/pdf/summary_of_tatfar_recommendation_1.pdf Accessed 18 December 2018

  9. Sartelli M, Duane TM, Catena F, Tessier JM, Coccolini F, Kao LS, de Simone B, Labricciosa FM, May AK, Ansaloni L, Mazuski JE (2016) Antimicrobial stewardship: a call to action for surgeons. Surg Infect 17(6):625–631. https://doi.org/10.1089/sur.2016.187

    Article  Google Scholar 

  10. Public Health England. (2015) Start smart - then focus antimicrobial stewardship toolkit for English hospitals. https://assetspublishingservicegovuk/government/uploads/system/uploads/attachment_data/file/417032/Start_Smart_Then_Focus_FINALPDF Accessed 18 December 2018

  11. Farren D, Nagar A, Dorgan E et al. (2017) Antibiotic Therapy (First-line Empirical) In Hospitalised Adults. Available on NHSCT Intranet. Accessed 23 December 2018

  12. Yeo JM (2016) Antimicrobial stewardship: improving antibiotic prescribing practice in a respiratory ward. BMJ Qual Improv Rep 5(1):w3570. https://doi.org/10.1136/bmjquality.u206491.w3570

    Article  Google Scholar 

  13. Leeds IL, Fabrizio A, Cosgrove SE, Wick EC (2017) Treating wisely: the surgeon’s role in antibiotic stewardship. Ann Surg 265(5):871–873. https://doi.org/10.1097/SLA.0000000000002034.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Llewelyn MJ, Hand K, Hopkins S, Walker AS (2015) Antibiotic policies in acute English NHS trusts: implementation of ‘Start Smart-Then Focus’ and relationship with Clostridium difficile infection rates. J Antimicrob Chemother 70(4):1230–1235. https://doi.org/10.1093/jac/dku515.

    Article  CAS  PubMed  Google Scholar 

  15. Sartelli M, Labricciosa FM, Barbadoro P, Pagani L, Ansaloni L, Brink AJ, Carlet J, Khanna A, Chichom-Mefire A, Coccolini F, di Saverio S, May AK, Viale P, Watkins RR, Scudeller L, Abbo LM, Abu-Zidan FM, Adesunkanmi AK, al-Dahir S, al-Hasan MN, Alis H, Alves C, Araujo da Silva AR, Augustin G, Bala M, Barie PS, Beltrán MA, Bhangu A, Bouchra B, Brecher SM, Caínzos MA, Camacho-Ortiz A, Catani M, Chandy SJ, Jusoh AC, Cherry-Bukowiec JR, Chiara O, Colak E, Cornely OA, Cui Y, Demetrashvili Z, de Simone B, de Waele JJ, Dhingra S, di Marzo F, Dogjani A, Dorj G, Dortet L, Duane TM, Elmangory MM, Enani MA, Ferrada P, Esteban Foianini J, Gachabayov M, Gandhi C, Ghnnam WM, Giamarellou H, Gkiokas G, Gomi H, Goranovic T, Griffiths EA, Guerra Gronerth RI, Haidamus Monteiro JC, Hardcastle TC, Hecker A, Hodonou AM, Ioannidis O, Isik A, Iskandar KA, Kafil HS, Kanj SS, Kaplan LJ, Kapoor G, Karamarkovic AR, Kenig J, Kerschaever I, Khamis F, Khokha V, Kiguba R, Kim HB, Ko WC, Koike K, Kozlovska I, Kumar A, Lagunes L, Latifi R, Lee JG, Lee YR, Leppäniemi A, Li Y, Liang SY, Lowman W, Machain GM, Maegele M, Major P, Malama S, Manzano-Nunez R, Marinis A, Martinez Casas I, Marwah S, Maseda E, McFarlane ME, Memish Z, Mertz D, Mesina C, Mishra SK, Moore EE, Munyika A, Mylonakis E, Napolitano L, Negoi I, Nestorovic MD, Nicolau DP, Omari AH, Ordonez CA, Paiva JA, Pant ND, Parreira JG, Pędziwiatr M, Pereira BM, Ponce-de-Leon A, Poulakou G, Preller J, Pulcini C, Pupelis G, Quiodettis M, Rawson TM, Reis T, Rems M, Rizoli S, Roberts J, Pereira NR, Rodríguez-Baño J, Sakakushev B, Sanders J, Santos N, Sato N, Sawyer RG, Scarpelini S, Scoccia L, Shafiq N, Shelat V, Sifri CD, Siribumrungwong B, Søreide K, Soto R, de Souza HP, Talving P, Trung NT, Tessier JM, Tumbarello M, Ulrych J, Uranues S, van Goor H, Vereczkei A, Wagenlehner F, Xiao Y, Yuan KC, Wechsler-Fördös A, Zahar JR, Zakrison TL, Zuckerbraun B, Zuidema WP, Catena F (2017) The Global Alliance for Infections in Surgery: defining a model for antimicrobial stewardship-results from an international cross-sectional survey. World J Emerg Surg 12:34. https://doi.org/10.1186/s13017-017-0145-2

    Article  PubMed  PubMed Central  Google Scholar 

  16. Davey P, Marwick CA, Scott CL, Charani E, McNeil K, Brown E, Gould IM, Ramsay CR, Michie S, Cochrane Effective Practice and Organisation of Care Group (2017) Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database Syst Rev 2:CD003543. https://doi.org/10.1002/14651858.CD003543.pub4.

    Article  Google Scholar 

  17. Ashiru-Oredope D, Budd EL, Bhattacharya A, Din N, McNulty CAM, Micallef C, Ladenheim D, Beech E, Murdan S, Hopkins S (2016) Implementation of antimicrobial stewardship interventions recommended by national toolkits in primary and secondary healthcare sectors in England: TARGET and Start Smart Then Focus. J Antimicrob Chemother 71(5):1408–1414. https://doi.org/10.1093/jac/dkv492

    Article  CAS  PubMed  Google Scholar 

  18. Donnelly P, Lawson S, Watterson C (2015) Improving paediatric prescribing practice in a district general hospital through implementation of a quality improvement programme. BMJ Qual Improv Rep 4(1):w3769. https://doi.org/10.1136/bmjquality.u206996.w3769

    Article  Google Scholar 

  19. Popovski Z, Mercuri M, Main C, Sne N, Walsh K, Sung M, Rice T, Mertz D (2015) Multifaceted intervention to optimize antibiotic use for intra-abdominal infections. J Antimicrob Chemother 70(4):1226–1229. https://doi.org/10.1093/jac/dku498.

    Article  CAS  PubMed  Google Scholar 

  20. Tonkin-Crine S, Walker AS, Butler CC (2015) Contribution of behavioural science to antibiotic stewardship. BMJ 350:h3413. https://doi.org/10.1136/bmj.h3413

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Northern HSC Trust, Causeway Hospital, 4 Newbridge Road, Coleraine, BT52 1HS, Northern Ireland

    David N. Johnston, Fatemeh Keshtkar & William Campbell

Authors
  1. David N. Johnston
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fatemeh Keshtkar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. William Campbell
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David N. Johnston.

Ethics declarations

This article does not contain any studies with human participants or animals performed by any of the authors.

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Johnston, D.N., Keshtkar, F. & Campbell, W. The effect of re-audit and education on antibiotic prescribing practice at Causeway Hospital, Northern Ireland. Ir J Med Sci 188, 1149–1153 (2019). https://doi.org/10.1007/s11845-019-01995-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11845-019-01995-9

Keywords

Search

Navigation