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Here we will report the effect of the implementation of EPMA

on adherence to the UK antimicrobial stewardship guidelines (start

smart, then focus) and compliance with Trust guidelines and policies.

We describe the effects on the MDT stewardship rounds, use of

protected antimicrobials

, and the audit and feedback programme

within the Trust.

We also discuss the stewardship enablers built into the system and

identify future work required to further improve the utility of the


Discussion and/or Conclusion(s):

Implementation of EPMA has had

significant affects on stewardship activities within the hospital.

Further work is required to optimise its use.

ID: 4729

Investigation of the utility of the ICNET NG Clinical Surveillance

Software to record interventions made during hospital

Antimicrobial Stewardship Wardrounds

Anne Duguid, Edward James.

NHS Borders


The benefits of multidisciplinary wardrounds in promot-

ing good antimicrobial stewardship have been previously described.

Antimicrobial Stewardship (AMS) Wardrounds require access to

current data on the patients under their review and should have a

secure system of recording their activity for future reporting. In this

regard the usefulness of the ICNET NG system in surveillance by

hospital Infection Control and Prevention Teams has been well



This study investigated the potential to extend

the use of the system to hospital AMS wardrounds.


Data on patients referred to the AMS wardround at a

general hospital were recorded using the ICNET NG

live staging

system. The reasons for referral were classified into one of three

categories (alert antimicrobials, aminoglycoside courses >3 d, clinical

pharmacist request). Outcomes after AMS wardround were classified

into one of five categories (continue, change, stop, IV to oral switch,

referral for outpatient antibiotic therapy (OPAT). The system was

qualitatively compared to the previous paper-based method by users


Data on patients referred to the AMS wards round over a

period of 6 months was reviewed. Users

experience of using the ICNET

software suggested benefits of the electronic system in terms of

accessibility to relevant patient data and ease of activity reporting

Discussion and/or Conclusion(s):

The ICNET NG Clinical Surveillance

software can be used as a patient monitoring and recording tool for

AMS wardrounds.

ID: 4744

Evaluating the prescribing of carbapenems and piperacillin/

tazobactam in acute hospitals in NHS Scotland

Jacqueline Sneddon


, Alison Cockburn


, Abdulrhman Mohana



Siân Robson


, Alex Mullen


, Marion Bennie


, William Malcolm



R. Andrew Seaton




Healthcare Improvement Scotland,


NHS Lothian,


University of Strathclyde,


NHS National Services Scotland,


NHS Greater

Glasgow and Clyde


Guidance from the Scottish Antimicrobial Prescribing

Group on use of carbapenems and piperacillin/tazobactam (piptaz)

was implemented through incorporation into local guidance in 2014.


Our aimwas to establish the extent to which this

local guidance was being translated into clinical practice.


A bespoke point prevalence study (PPS) was performed in

acute hospitals during October 2015 using a validated web-based tool

to determine whether prescribing complied with local guidance.

Anonymised data from all patients prescribed these antibiotics was

collected, input to the PPS website and local reports generated. Data

for all boards were then aggregated to create national reports.


The PPS was completed by 13 of the 15 health boards and 478

prescriptions were analysed. Results showed that compliance with

prescribing policies for use of meropenem, the most frequently used

carbapenem, was high but compliance varied considerably for piptaz.

Documentation of indication for use was recorded in 90% of

meropenem prescriptions but was less well documented for piptaz

use. Documentation of a review or stop date for both meropenem and

piptaz varied greatly (0

100%) but was generally low. Board-level data

have allowed identification of boards with high compliance with these

measures, and sharing of good practice.

Discussion and/or Conclusion(s):

This study demonstrates variation

in practice across Scotland and is the second stage of an improvement

programme to optimise the use of meropenem and piptaz. Further

qualitative work is ongoing to evaluate clinician behaviour in use of

these antibiotics to inform a national improvement plan.

ID: 4745

Development of pharmaceutical care as part of antimicrobial

stewardship intravenous to oral switch (IVOS) ward-rounds

Alison Cockburn, Esperanza Palenzuela, Jenny Carson.

NHS Lothian


IVOS ward-rounds were implemented in NHS Lothian

acute hospitals in 2014 as a means of improving antimicrobial

stewardship. The contribution of the Antimicrobial Pharmacists


these ward-rounds to achievement of improved antimicrobial pre-

scribing has not been formally assessed before.


The aim of this study was to assess the effec-

tiveness of the Antimicrobial Pharmacists

contribution to achieve-

ment of improvements in antimicrobial stewardship as part of the

IVOS ward-rounds programme in NHS Lothian.


All pharmaceutical care interventions were recorded by

the Antimicrobial Pharmacists on eight IVOS rounds. The interventions

were reviewed by NHS Lothian

s Antimicrobial Team (AMT) and risk

assessed for possible adverse outcomes for patients. The results were

feedback to the medical staff as part of an antimicrobial stewardship

education programme to help improve safe antimicrobial prescribing.


A total of 240 patients were reviewed during the eight IVOS

rounds. 46 additional interventions and 29 referrals to medical staff

were made by the pharmacist. The majority of the pharmaceutical care

interventions were assessed as being moderate to high risk for

possible adverse patient outcomes.

These interventions were used to inform an antimicrobial stewardship

education programme which was delivered to the 4 wards where the

IVOS study was undertaken.

Discussion and/or Conclusion(s):

Documentation and assessment

of pharmaceutical care interventions on IVOS ward-rounds is a novel

approach to improvement of antimicrobial stewardship by medical

staff. Review of the Antimicrobial Pharmacists

interventions and

subsequent development of an education programme for junior

medical staff on antimicrobial stewardship has facilitated achievement

of improved antimicrobial prescribing.

ID: 4750

Antimicrobial Stewardship: assessing the knowledge, attitudes and

perceptions of future prescribers

Mohammed Al-Talib


, Eben Jones


, Martin Llewelyn




Brighton and

Sussex University Hospitals Trust,


Brighton and Sussex Medical School


Antimicrobial resistance is recognised as a major threat

to global health, with inappropriate prescribing identified as a key

factor in promoting resistance. With the threat of a

post-antibiotic era

looming, it is the next generation of doctors who will be at the

forefront of the battle against antimicrobial resistance.


We sought to explore the knowledge, attitudes

and perceptions among fourth year medical students at Brighton and

Sussex Medical School (UK) regarding antimicrobial stewardship.


We distributed a knowledge, attitudes and perceptions

survey to fourth year medical students completing their formal

Infectious Diseases module. The surveys were completed during

teaching session and then formed the basis for discussion.


There were a total of 91 respondents over five separate

sessions from April 2015

March 2016. Just 36% of students

were familiar with the term

antimicrobial stewardship

. Students

Abstracts of FIS/HIS 2016

Poster Presentations / Journal of Hospital Infection 94S1 (2016) S24