The Journal of Hospital Infection - Supplement 1 - November 2016

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Results: 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
system.
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
Background: 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
established.
Aim(s)/Objective(s): This study investigated the potential to extend
the use of the system to hospital AMS wardrounds.
Method(s): 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
Results: 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 1, Alison Cockburn2, Abdulrhman Mohana3,
Siân Robson 1, Alex Mullen3, Marion Bennie3, William Malcolm 4,
R. Andrew Seaton5. 1Healthcare Improvement Scotland, 2NHS Lothian,
3University of Strathclyde, 4NHS National Services Scotland, 5NHS Greater
Glasgow and Clyde
Background: Guidance from the Scottish Antimicrobial Prescribing
Group on use of carbapenems and piperacillin/tazobactam (piptaz)
was implemented through incorporation into local guidance in 2014.
Aim(s)/Objective(s): Our aimwas to establish the extent to which this
local guidance was being translated into clinical practice.
Method(s): 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.
Results: 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
Background: 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’ on
these ward-rounds to achievement of improved antimicrobial pre-
scribing has not been formally assessed before.
Aim(s)/Objective(s): 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.
Method(s): 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.
Results: 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-Talib1, Eben Jones1, Martin Llewelyn2. 1Brighton and
Sussex University Hospitals Trust, 2Brighton and Sussex Medical School
Background: 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.
Aim(s)/Objective(s): We sought to explore the knowledge, attitudes
and perceptions among fourth year medical students at Brighton and
Sussex Medical School (UK) regarding antimicrobial stewardship.
Method(s): 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.
Results: 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–S134 S38