AimAn audit of compliance with NICE guideline CG149 for the management of early onset neonatal sepsis (EONS) undertaken at this hospital indicated underperformance with respect to duration of antibiotic treatment and choice of benzylpenicillin dose. A re-audit was carried out to evaluate the impact of measures introduced to improve compliance, with a particular focus on duration of antibiotic treatment.MethodResults of the initial audit were presented to the department, leading to the selection of champions for change. An intervention strategy was devised, which comprised of introducing a new section to the neonatal handover list, whereby date and time when repeat CRP and review of blood cultures should take place was clearly documented, together with results as they became available. This intervention was introduced at a departmental meeting, and received enthusiasm from junior doctors and consultants. Both audits were retrospective, spanning 12 months and 5 months respectively. Data were retrieved from case notes and the Trust’s electronic laboratory management system.ResultsThe findings presented in the table 1 show that;audits analysed >75% of the cases of suspected EONS;proportion of babies receiving ≤48 hours of antibiotics increased from 18.5% to 69%;proportion of babies receiving a full 7 day course of treatment increased from 35% to 82%;compliance with benzylpenicillin dosing increased to 100%.Abstract G134(P) Table 1 Original Audit (12 months ) Re-audit (5 months ) p* Babies tested for suspected EONS, n 204 106 Casenotes reviewed, n (%) 159 (78) 80 (75.5) 0.95 Babies without sepsis receiving≤48 hours of antibiotics,% 18.5 69 <0.0001 Babies with sepsis receiving 7 days of antibiotics,% 35 82 0.02 50 mg/kg dose of benzylpenicillin used for meningitis only,% 0 100 <0.0001 *Mann-Whitney testConclusionIntroducing a robust system for ensuring the timely review of CRP and blood culture results has improved overall compliance with NICE guidelines, and in particular, has significantly reduced the number of babies receiving inappropriate durations of antibiotic treatment.

The incidence of prostate cancer continues to rise and is now the most common cancer in men in Wales and in the UK (Cancer Research UK, 2010). More men are being referred via the urgent suspected cancer (USC) pathway for further investigations than ever before. Pressure on urology departments from government targets and cancer waiting times has led to the need to find pioneering ways to meet these demands, while maintaining high standards of care. This article presents a retrospective audit that compared the practice of a nurse specialist to a urologist while undertaking transrectal ultrasound with prostatic biopsies, the definitive investigation in the detection of prostate cancer. Results have shown that the nurse‐led service is equivalent to that of the urologist in cancer detection and morbidity rates. The audit has shown that the nurse‐led prostate biopsy clinic is both effective and safe in practice. In addition, the service has reduced the waiting times for patients needing this procedure to less than a week.