71 Electronic Prescribing Promotes Antimicrobial Stewardship In Surgery: A Closed-Loop Audit. (4th May 2021)

• Record Type: Journal Article
• Authors: Lee, A; Kelly, M; Maden, C; McHardy, J; Elfadl, D
• Is Part Of: British journal of surgery. Volume 108(2021)Supplement 2
• Publication Date: 2021-05-04
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1093/bjs/znab134.359
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract: Introduction: Antimicrobial resistance is increasing globally. Surgical inpatients are more likely to receive inappropriately broad-spectrum and prolonged antimicrobial treatment, against local policy. Electronic prescribing (e-prescribing) has the potential to promote antimicrobial stewardship. We conducted a closed-loop audit to assess the impact of e-prescribing on surgical inpatient prescriptions. Method: Audit standards (from Public Health England) included: (1) documentation of allergy status, prescriber contact information, antimicrobial indication and review/stop dates; and (2) prescription of appropriate antimicrobials for appropriate durations (IV and total). Prospective data collection occurred over 1-week. The interventions included an educational session, a once weekly microbiology round of surgical inpatients and the introduction of e-prescribing (Cerner©). Results: Compliance improved significantly between cycle 1 (n = 54 prescriptions) and 2 (n = 59 prescriptions), for: documentation of prescriber contact details (69 vs 100%) and appropriate antimicrobial review/stop dates (17 vs 100%), indications (78 vs 96%), selection (76 vs 90%) and IV and total antibiotic duration (63 vs 93% and 87 vs 100%, respectively); p < 0.05 throughout. Conclusions: Audit compliance improved significantly, partly because Cerner© prompts clinicians to input contact details, review dates and indications before prescribing. E-prescribing in combination with appropriate education is likely to promote antimicrobial stewardship and should be considered by other Trusts using paper prescriptions.