Transcript Slide 1
ANTIMICROBIAL PLAN STICKER
Improving Antimicrobial documentation with the
use of an Antimicrobial Plan sticker
Evonne Fong, Pharmacy Department AHS, ICU
AHS
Background
Australian Commission on Safety and Quality in Health Care
• Consultation Draft: Clinical Care Standard for antimicrobial
stewardship (Dec 2013)
Quality Statement 6
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Clinical reason
Drug name
Dose
Route of administration
Intended duration
Review plan
Baseline
NAPS audit November 2013
• One day “snap shot”
• 85 antimicrobial orders
• Documentation of indication = 67.1%
– Med chart, patient’s notes, anaesthetic/surgical/other
procedural records
– Excludes nursing hand over notes or other non-official
records
NIMC audit 2012
• Regular orders with indication
documented on NIMC = 7.93%
Aim
To improve documentation of antimicrobial treatment
• Best practice: >95%
To have effective communication between clinicians
To ensure there is a system in place at AHS to support
documentation and communication
Methodology
Trial 1:
Pilot of new sticker in consultation
with ICU director
Sticker covers documenting
requirements
Promoted in Pharmacy Newsletter
ICU doctors emailed; discussed with
doctors on floor
Methodology
RESULTS:
After 2 weeks:
Documentation of indication = 86%
(n = 29)
• compared to 67.1% at baseline
• Good sticker use with initial doctors
rotation/shift change poor
compliance
• Stickers used for 41% of
antimicrobial orders
• Stickers disappearing
• Drs unaware/unsure intention
Methodology
RE-LAUNCH :
• Discussion with doctors and nurses
• New sticker designed to use in med chart instead
Methodology
Drs emailed
Registrars spoken to
individually (handover
time and registrar
“champion”)
Discussed at ICU
management meeting
with consultant and
CNS
Ward clerk enlisted to
assist
Results
10 days auditing post re-launch:
96% compliance with documenting indication (n = 24)
Sticker used for 83% of antimicrobial orders
Other results:
• Drug name, dose, route = 100%
• Intended duration/review plan: 71%
Work in progress…
Addressing issues
as they arise
New doctors
soon
Re-educate and
remind
Conclusion
Reached indication target of 95%.
• Regular re-auditing
Look to improve documentation of intended duration and
review plan
Roll out to other wards
• ICU transfers to other wards launch officially on other wards
• Dr education