CQUIN audit for prescription of antibiotics for XXXX in an acute medical assessment unit.

@entity1 @entity293
@entity293 ( @entity293 ) are a common presentation in a medical assessment unit, and we wanted to check compliance with hospital guidelines for antibiotic prescribing in @entity1 presenting to hospital with @entity293 . The guidelines are based on local organisms and sensitivities. A retrospective audit of 40 @entity1 records with positive urine cultures from July to August 2013 showed that 20% of @entity1 with culture confirmed @entity293 were not given antibiotics at all. Of those prescribed antibiotics, 25% were non-compliant with local policy, and nearly one in two @entity1 received more than one antibiotic. Furthermore, stop dates were not stated on 77% of the drug charts and duration of treatment ranged from one to 11 days. Interventions were then introduced in the form of group teaching sessions, proactive checks by Trust pharmacists and widely distributed posters, and the same data sets collected for April to March 2014 to assess for efficacy of the interventions. On re-auditing, 35% @entity1 were not prescribed any antibiotics. However, compliance with local policy was 100%, including 100% drug charts having a stop/review date stated. The overall duration of treatment now ranged from one to seven days, and fewer than one in four @entity1 had more than one antibiotic. Our results showed that improvement was needed in antibiotic stewardship, in particular with regards to compliance with the local guidelines and documentation of prescription. We have demonstrated that it is possible to improve compliance through teaching, by displaying information prominently, and vigilance by the clinical team. The outcome of this is a decreased number and duration of antibiotics prescribed, which has benefits for the @entity1 , the hospital, and the community as a whole. Further work would include interventions to improve the number of @entity1 who are missing antibiotic prescriptions altogether.
