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Increasing the documentation of 48-hour antimicrobial reviews
  1. Ramandeep Singh Sahota1,
  2. Kiran Kasper Rajan1,
  3. Jonathan Mark Sabine Comont1,
  4. Hyungeun Hans Lee1,
  5. Nikolina Johnston1,
  6. Mary James2,
  7. Rakhee Patel2,
  8. Joseph Nariculam2
  1. 1Medical School, GKT School of Medicine, London, UK
  2. 2Department of Surgery, Darent Valley Hospital, Dartford, Kent, UK
  1. Correspondence to Ramandeep Singh Sahota; ramandeep.sahota{at}kcl.ac.uk

Abstract

Antimicrobial resistance is a growing problem worldwide. Encouraging antimicrobial stewardship can help to reduce the negative consequences of inappropriate antibiotic use. This quality improvement project targets to do this by aiming to improve the proportion of 48-hour antimicrobial reviews completed and documented on two surgical wards at Darent Valley Hospital with a goal of 100% compliance.

This project used four PDSA (plan, do, study, act) cycles to achieve our aim: a trust-wide email; education sessions with junior doctors; sticker reminders in patient notes; presenting our study to surgical consultants and displaying posters on the wards.

The proportion of antimicrobial reviews completed at 48 hours in the patient notes increased from 18% to 77% over 19 weeks from 10 October 2018 to 20 February 2019. The most successful intervention was providing a presentation for consultants at an audit meeting in conjunction with displaying posters on the wards.

The most successful interventions (education sessions with junior doctors and presentation to surgical consultants alongside displaying posters on the wards) were found to be those that required minimal further input after their initial rollout. This project was carried out by medical students and is highly transferrable to other hospitals, and highlighted that a successful quality improvement project can be undertaken by any member of the healthcare team.

  • antibiotic management
  • quality improvement
  • clinical practice guidelines
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Footnotes

  • Contributors RSS: designed the study, was involved in the implementation of interventions, data collection, data analysis, drafting of the manuscript, writing the final manuscript, revised the manuscript for intellectual content and is responsible for the overall content of the study. KKR: designed the study, was involved in the implementation of interventions, data collection, data analysis, drafting of the manuscript, writing the final manuscript and revising the manuscript for intellectual content. JMSC, HHL and NJ: designed the study, were involved in the implementation of interventions, data collection, data analysis and drafting of the manuscript. MJ, RP and JN: designed the study, were involved in the implementation of interventions and oversaw the progress of the interventions in a supervision role for the five medical students (RSS, KKR, JMSC, HHL and NJ).

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article.

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