Use of a preprinted sticker to improve the prescribing of prophylactic antibiotics for hip fracture surgery

Ritchie, Stephen

doi:10.1136/qhc.13.5.384

Cited by 3 publications

(1 citation statement)

References 8 publications

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“…14 15 Pre-printed chart stickers improve compliance with prophylactic antibiotic guidelines. 16 Abolition of peak levels, contacting clinicians, education and computer ''pop-up'' screens were used to optimise vancomycin TDM in Yale University, which succeeded with a 60% decrease in TDM requests, sustained at one year. 14 Unlike the Yale study, our main aim was to improve vancomycin administration, but there was also a decrease in our TDM requests (table 3).…”

Section: Discussionmentioning

confidence: 99%

Vancomycin administration: the impact of multidisciplinary interventions

Crowley

Fitzpatrick²,

Solanki³

et al. 2007

J Clin Pathol

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Background:The clinical microbiology team observed that patients were not receiving all prescribed doses of vancomycin. Ward staff was confused about ordering and interpreting vancomycin therapeutic drug monitoring (TDM) levels. Aim: To audit the incidence of vancomycin dose omission. To implement a series of interventions to improve vancomycin dose administration, and to repeat the audit process to assess these interventions. Methods: Three prospective audits were conducted to assess the impact of vancomycin TDM on administration of vancomycin. After the first audit, a number of changes in the TDM process were undertaken. After review of the second audit, a senior pharmacist coordinated ward-based pharmacists in assisting staff to interpret levels, and TDM interpretative charts were designed for drug charts. Following the third audit, feedback to hospital management and a plan for ongoing education were undertaken. Results: There was a significant reduction in the number of vancomycin doses held inappropriately in the third (10% (78/782) of prescribed doses) when compared to the first audit (16% (161/1007) of doses) (p,0.01). Of doses that were held inappropriately, there was a significant decrease in doses held for no apparent reason in audit 3 (16% (27/170) of prescribed doses) when compared to audit 1 (25% (69/282) of doses) (p,0.05). Conclusions:The interventions resulted in a 37.5% reduction in inappropriately held vancomycin doses over a one-year period; 10% of doses are still being held inappropriately. This study highlights the difficulties in identifying barriers to change and changing healthcare worker behaviour.

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Section: Discussionmentioning

confidence: 99%

Vancomycin administration: the impact of multidisciplinary interventions

Crowley

Fitzpatrick²,

Solanki³

et al. 2007

J Clin Pathol

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Drug utilization review across jurisdictions – a reality or still a distant dream?

Pulver

Tett

2006

Eur J Clin Pharmacol

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Improving patient portal enrolment in an academic resident continuity clinic: quality improvement made simple

et al. 2019

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Electronic health record patient portal usage has been associated with improvement in chronic disease parameters, patient functional status and patient satisfaction. Our institution’s patient portal is a secure, online health management tool that connects patients to portions of their electronic health record.Our quality improvement project aimed to increase patient portal enrolment significantly in our Internal Medicine resident patient panels.This study was conducted in a large, multisite health system in Kansas City, Kansas that serves a diverse patient population. Our clinic includes 65 resident patient panels. We followed a subset of 16 resident patient panels in this quality improvement project. A baseline audit showed that 35% of the 1628 patients in these panels were enrolled in the patient portal system. A standardised, nurse-initiated portal sign-up process following patient rooming was implemented. Initial results indicated a 9.6% increase in patient portal sign-up at the end of the first 4-week cycle. We then implemented educational sessions for our clinic nurses as well as attending physicians, and achieved a 15.1% increase from baseline to the end of the second 4-week cycle, resulting in 86 patient portal activations (p<0.01).Resident physicians worked with clinic nurse partners in two formats for this project. Nurses assigned to patient rooming for residents during the clinic sessions being studied (rooming nurses) initiated the portal sign-up process. Nurses assigned to partner with the resident for longitudinal patient care management, anchor nurses, worked with residents on items such as phone messages or portal messages. Semi-structured interviews of the four anchor nurses aligned with the 16 residents were conducted at the end of the study and revealed that nursing staff perceived increased patient portal activity to be associated with a decrease in nursing workload and an increase in patient engagement.

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Use of a preprinted sticker to improve the prescribing of prophylactic antibiotics for hip fracture surgery

Cited by 3 publications

References 8 publications

Vancomycin administration: the impact of multidisciplinary interventions

Vancomycin administration: the impact of multidisciplinary interventions

Drug utilization review across jurisdictions – a reality or still a distant dream?

Improving patient portal enrolment in an academic resident continuity clinic: quality improvement made simple

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