P-127 Antimicrobial stewardship – improving prescribing on the inpatient unit

Introduction The Inpatient Unit at Dorothy House Hospice Care committed to comply with national guidelines for antibiotic prescribing. The document followed was the Department of Health’s ‘Antimicrobial Stewardship: Start Smart Then Focus’. Although the guidance had been produced for hospitals the guiding principles were also applicable in the hospice setting. We also wanted to ensure compliance with Criterion 3 of the Health and Social Care Act 2015 where it states “Ensure appropriate antimicrobial use to optimise patient outcomes and to reduce the risk of adverse events and antimicrobial resistance”. Aims The aims were to ensure Dorothy House was compliant with local and national guidelines on antibiotic prescribing To identify how antibiotics are prescribed and supplied by Dorothy House and to improve antimicrobial stewardship. Methods A patient database was set up to capture all patients prescribed antibiotics. Standards were set to ensure: Compliance with local guidelines Documented indication for antibiotic use was on the medicine chart Documented indication for use was in the patient notes The prescription was clear and accurate A review date or duration of antibiotic use was prescribed Compliance with The Department of Health Advisory Committee on antimicrobial stewardship A quarterly audit using the above standards was performed capturing all patients prescribed antibiotics in that time period Conclusion There was a dramatic improvement in compliance from the quarter one audit to the quarter four audit in all standards but most specifically around documenting an indication for use on prescription charts and setting a review or duration date. There was also a decrease in the use of broad spectrum antibiotics. This audit now forms part of the Dorothy House Hospice Care annual audit plan.