40 / 150
(47% vs. 89%), respectively. Combined POCT resulted in the best
sensitivity (98%) and specificity (81%). Nearly one in ten patients
received an antimicrobial to which the organism was not fully
sensitive.
Discussion and/or Conclusion(s):
One rapid, cost-effective POCT was
too inaccurate to be used alone by healthcare workers, impeding
antibiotic stewardship in a high ESBL setting. Appropriate prescribing
is improved with concurrent use and concordant results of urine
dipstick and microscopy.
ID: 4469
Development of an antimicrobial stewardship peer review system
for the East of England Pharmacy Infection Network
Emma Cramp.
Hinchingbrooke NHS Hospital
Background:
There have been a number of UK national guidelines to
support Antimicrobial Stewardship pulished recently. The diversity of
these resources, given that they have been produced by different
expert groups, and at different time points, makes it challenging for
teams to establish which guidance to follow. In response to this,
the recommendations from these national resources were reviewed
and collated into one complete AMS tool to provide clarity to enable
the recommendations to be followed. The intention is to use the tool
to enable a peer reviewof AMS activities in acute NHS Trusts in the East
of England region.
Aim(s)/Objective(s):
To develop a tool to facilitate the peer review of
antimicrobial stewardship activities in acute hospitals in the EoE.
Method(s):
Guidance from national documents relating to antimicro-
bial stewardship were reviewed and used to formulate a draft tool. This
tool was circulated to the EoE regional antimicrobial pharmacist
’
s
network for comment. The draft tool was used as part of a pilot peer
review visit at two acute hospitals.
Results:
Feedback received from the participants of the pilot peer
review informed the publication of the final peer review tool. The tool
was able to identify gaps in antimicrobial stewardship practice at each
site.
Discussion and/or Conclusion(s):
The next stage of implementation
will be to adopt a peer review process using the tool across the East of
England region. We hope that this system will provide a unique and
systematic review of AMS activities and lead to recommendations for
improvement and sharing of best practice throughout the region.
ID: 4515
Surgeons when it comes to managing cutaneous abscesses know
about your ISAs (Incisions, Swabs and Antibiotic stewardship)
Richard Pilkington
1
, Jonathan Moore
2
, Luke Banbury
3
.
1
Health
Education North East,
2
Dept of Microbiology, Gateshead NHS Trust,
3
Foundation Dr, Queen Elizabeth Hospital Gateshead
Background:
Cutaneous abscesses are commonly encountered in
clinical practice. Conventional wisdom dictates that incision and
drainage (I+D) is the treatment of choice. The role of antibiotics
and microbiological sampling at the time of drainage is less well
established. Our hospital has a successful pathway to identify and
manage patients requiring surgical intervention.
Aim(s)/Objective(s):
We evaluate what microbiology samples are sent
and how useful these results are, as well as considering what therapy
patients on this pathway receive with the intention of improving the
pathway and antibiotic stewardship.
Method(s):
109 cases of I + D were reviewed. For each case, we
identified if swabs were taken and if antibiotics were prescribed and
then analysed the culture results.
Results:
Of 109 I + D carried out (66 perianal, 24 abdominal, 16
axilla/breast and 3 lower limb), swabs were taken in 100 cases. 37% of
samples were culture negative. As expected, Gram negative and
anaerobic florawere most frequently isolated form perianal swabs and
Gram positive flora from other sites. Varied antibiotic practice was
noted.
Discussion and/or Conclusion(s):
The mainstay of treatment for
cutaneous abscess is surgical I + D. Our hospital pathway works well in
identifying patients requiring I + D and conducting this surgery.
However, presently samples are sent in the majority of cases and
antibiotic practice variable. We propose that our pathway is developed
to provide a selective framework for cases where microbiology
work up is likely to be most beneficial and to improve antibiotic
stewardship both before and after I + D to make best use of precious
resources.
ID: 4520
Implementing an antimicrobial stewardship training and
mentorship programme and encouraging key nurse led
‘
antibiotic
conversations
’
Frances Kerr, Paula Smith, David Watson, Steve McCormick.
NHS
Lanarkshire
Background:
Antimicrobial resistance is a recognised issue. Nurses
with more patient contact than other health professionals are in a key
position to influence safe, effective prescribing and administration of
antibiotics.
Aim(s)/Objective(s):
To implement a ward based antimicrobial
stewardship programme for nurses highlighting key opportunities
for intervention, encouraging
‘
antibiotic conversations
’
and acting as
effective safety nets.
Method(s):
Ward buzz session ran over 6 weeks fromMay
–
June 2015.
Materials and training were tested separately. Training was focused
on antibiotic policies and key opportunities to initiate antibiotic
conversations. Pre/post training questionnaires were used to assess
the impact of training and nurse confidence levels. Paired T-test was
used to assess impact.
Results:
13 nurses were trained and 12 pre/post questionnaires were
returned. 83% (n = 10) of nurses said it changed their practise. 100%
would recommend training to colleagues.
A statistically significant increase in confidence in initiating conver-
sations (p = 0.046) was observed. Pre-training 75% of nurses had
≤
2
conversations per week, post-training 67% had
≥
3 conversations.
A statistically significant increase in confidence assessing vancomycin
levels (P = 0.005) was demonstrated. No significant change in con-
fidence with gentamicin was seen (p = 0.054).
Overall nurses were more confident at querying antibiotic prescribing,
a clear safety benefit for patients.
Discussion and/or Conclusion(s):
Although the sample size was
small, nurses showed increased awareness of antibiotic policies and
increased confidence in using them, resulting in increased nurse
initiated antibiotic conversations. Nurse feedback was very positive,
they felt strongly that this training would benefit their colleagues.
An action plan is being formulated to ensure rollout to all nursing staff.
ID: 4545
European Antibiotic Awareness Day (EAAD) activities
across Scotland: Views and experiences of the
community pharmacy team
Antonella Tonna
1
, Jacqui Sneddon
2
, Anita Weidmann
3
, Derek Stewart
3
.
1
Robert Gordon University School of Pharmacy and Life Sciences,
2
Scottish
Medicines Consortium,
3
Robert Gordon University
Background:
EAAD is a European wide public health initiative
encouarging responsible use of antibiotics amongst the general
public. Community Pharmacy teams across Scotland are supported
to partake in EAAD through activities coordinated by the Scottish
Antimicrobial Prescribing Group (SAPG). In 2014, this included using
a community pharmacy version of a self help guide published by
the Royal College of General Practitioners and distributed to all
community pharmacies.
Aim(s)/Objective(s):
To explore the views and experiences of
community pharmacy teams across Scotland of using this self help
guide.
Abstracts of FIS/HIS 2016
–
Poster Presentations / Journal of Hospital Infection 94S1 (2016) S24
–
S134
S35