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Scottish Antimicrobial Pharmacist Group SNAP-CAP & Empirical Prescribing Indicator Audit PowerPoint PPT Presentation


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Scottish Antimicrobial Pharmacist Group SNAP-CAP & Empirical Prescribing Indicator Audit 8 th June 2010. NHS Borders : smallest mainland Health Board area in Scotland population 112760 Age >60years group is above Scottish average

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Scottish Antimicrobial Pharmacist Group SNAP-CAP & Empirical Prescribing Indicator Audit

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Scottish antimicrobial pharmacist group snap cap empirical prescribing indicator audit

Scottish Antimicrobial Pharmacist Group

SNAP-CAP

&

Empirical Prescribing Indicator Audit

8th June 2010


Scottish antimicrobial pharmacist group snap cap empirical prescribing indicator audit

NHS Borders :

  • smallest mainland Health Board area in Scotland

  • population 112760

  • Age >60years group is above Scottish average

  • Increased incidence of hospitalization in older age groups.

  • 1 district Hospital

  • 293 beds


Audit plan for snap cap

Audit Plan for SNAP-CAP

  • Data collection/audit process

    • Medical Admission Unit/ A&E

    • Medical and nursing staff to capture appropriate patients

    • Aim to collect 10 a month

    • Lead Antimicrobial Nurse to collect material for monthly update to IHI.org

    • Feedback to clinicians by poster/ email


The story so far

….the story so far

  • Data collection

    • 2 referrals from A&E and then nothing

    • A few from MARU

    • What ‘no pneumonias?’

  • Review

    • Raising SNAP-CAP/CURB65 profile

    • Active pursuit of CAP’s

    • LRTI/Pneumonia: Data validated Respiratory Consultant


Curb65 i ve heard of it

CURB65: ‘I’ve heard of it’

  • Raising the profile of SNAP-CAP & CURB65

    • Nursing/ junior medical staff education

      • Small group/ face to face interaction

      • Daily pursuance of pneumonias

      • Rising above the challenges of doctor rotations

  • Number of patients with CAP collected

    • Variable: 8-18

    • Median monthly: 12


Chasing cap s

Chasing CAP’s

  • Active seeking of community acquired pneumonias

    • EDIS

    • Checking notes/ admission board/ asking etc

    • Unscheduled Care (BECS)

    • When is LRTI a pneumonia?

    • Reviewing X-ray reports


Itu have someone with cap

‘ITU have someone with CAP’

  • How the admission pathway actually operates!

    • Patients requiring supported care e.g. CURB65=3

      • Ward 5 (High Dependency Care)

      • ITU aware

  • Feedback to medical teams

    • Where did that poster go?

    • Opt-in email system for Junior Doctors

    • Micro site


Summary

Summary

  • Greater awareness of SNAP-CAP/CURB65

  • Consistency in data

  • Time consuming

  • Change may impact on results

  • However, imperfect results / variability

  • Challenge to improve implementation


Empirical prescribing indicator audit

Empirical Prescribing Indicator Audit

  • Medical Acute Receiving Unit

    • 30 bedded unit

    • High turnover of patients with infections

    • Usually good compliance with recording of indication and prescribing within the local guidelines

    • Medical staff on hand, usually several.


Scottish antimicrobial pharmacist group snap cap empirical prescribing indicator audit

  • Surgical Acute Admissions Unit

    • Small 11 bedded unit

    • Some issues

      • Challenge to capture 20 monthly

      • Indicator for antibiotic treatment not always clear

      • Do patients always require antibiotics?

      • Medical staff not always present but nursing staff appraised of any issues


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