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Increasing the documentation of 48-hour antimicrobial reviews

Ramandeep Singh Sahota1, Kiran Kasper Rajan2, Jonathan Mark Sabine Comont2

  • 1Medical School, GKT School of Medicine, London, UK ramandeep.sahota@kcl.ac.uk.

BMJ Open Quality
|February 9, 2020
PubMed

Insights

Antimicrobial stewardship improves antibiotic review compliance. A quality improvement project increased 48-hour antimicrobial reviews from 18% to 77% through targeted interventions.

Area of Science:

  • Healthcare Quality Improvement
  • Infectious Diseases
  • Pharmacology

Background:

  • Antimicrobial resistance (AMR) is a significant global health threat.
  • Inappropriate antibiotic use exacerbates AMR and its consequences.
  • Effective antimicrobial stewardship programs are crucial to mitigate these risks.

Purpose of the Study:

  • To enhance the completion rate of 48-hour antimicrobial reviews on surgical wards.
  • To achieve 100% compliance in documenting these critical reviews.
  • To implement and evaluate interventions within a quality improvement framework.

Main Methods:

  • Utilized four Plan-Do-Study-Act (PDSA) cycles for iterative improvement.
  • Implemented interventions including trust-wide emails, junior doctor education, patient note stickers, consultant presentations, and ward posters.
  • Monitored the proportion of 48-hour antimicrobial reviews over a 19-week period.

Main Results:

  • The proportion of completed 48-hour antimicrobial reviews increased from 18% to 77%.
  • The most effective interventions involved consultant presentations and ward posters.
  • Interventions requiring minimal post-rollout input demonstrated greater success.

Conclusions:

  • Targeted quality improvement initiatives can significantly improve antimicrobial stewardship practices.
  • Collaborative efforts, including medical student-led projects, can yield substantial improvements.
  • Successful strategies are often those that are easily integrated into existing workflows.
Keywords:
antibiotic managementclinical practice guidelinesquality improvement

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