Infection team review had a significant impact on antimicrobial use, facilitating iv to oral switch and a reduction in the volume of antibiotic use, possibly reducing the risk of healthcare-associated complications and infections. It identified many patients who could potentially have been managed in the community with appropriate resources, saving 481 bed-days. The health economics are reported in a companion paper.
While a prolonged admission and multiple operations are expected, early diagnosis and aggressive multimodal treatment may result in a significantly better survival outcome than those quoted in previous literature.
SynopsisThe implementation of electronic prescribing and medication administration systems (EPMAs) is a priority for hospitals and a potential component of antimicrobial stewardship (AMS).
ObjectivesThis study aimed to identify software features within EPMAs that could potentially facilitate AMS and to survey practising UK infection specialist healthcare professionals in order to assign priority to these software features.
MethodsA questionnaire was developed using nominal group technique and transmitted via email links through professional networks. The questionnaire collected demographic data, information on priority areas and anticipated impact of EPMA. Responses from different respondent groups were compared using the Mann Whitney U test.
ResultsResponses were received from 164 individuals (142 analysable). Respondents were predominantly specialist infection pharmacists (48%) or medical microbiologists (37%). 59% of pharmacists had experience of EPMA in their hospitals compared to 35% of microbiologists. Pharmacists assigned higher priority to: indication prompt (p<0.001), allergy checker (p=0.003) treatment protocols (p=0.003), drug-indication mismatch alerts (p=0.031) and prolonged course alerts (p=0.041); and lower priority to a dose checker for adults (p=0.02) and an interaction checker (p<0.05), than microbiologists. A "soft stop" functionality was rated essential or a high priority by 89% of respondents. Potential EPMA software features were expected to have the greatest impact on stewardship, treatment efficacy and patient safety outcomes with lowest impact on Clostridium difficile infection (CDI), antimicrobial resistance and drug expenditure.
ConclusionsThe survey demonstrates key differences in health professionals' opinions of different healthcare benefits of EPMA but a consensus of anticipated positive impact on patient safety and antimicrobial stewardship.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.