Quality assurance of data collection in an aminoglycoside dosing service

An aminoglycoside dosing service (ADS) has been in existence at the Hospital since 1984. As part of an overall Quality Assurance (QA) plan for the service, an audit was conducted to ensure that all necessary data were available to allow for proper interpretation of the serum aminoglycoside levels. The initial audit revealed complete documentation of required data in 75% of PRE-dose levels and 63% of POST-dose levels drawn. Several problems were identified: staff were not aware of procedures on how to complete the serum antibiotic level requisition forms; inaccurate assumptions of infusion times were made by pharmacists; and discrepancies were found to exist in the Hospital's Laboratory Manual and Pharmacy Intravenous Medication Manual. Corrective action was initiated through: education on proper documentation on the serum antibiotic level requisition forms through the hospital-wide distributed Pharmacy Bulletin; revision of the Hospital's Laboratory Manual and Pharmacy Intravenous Medication Manual; communication with head nurses to emphasize the need for documentation of infusion times; and active follow-up with nurses on missing information by the clinical pharmacist. A re-audit was initiated following implementation of the corrective actions. Complete documentation of required data increased to 93% with PRE-dose levels and 84% with POST-dose levels. This improvement was statistically significant (p less than 0.001).