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    The Champions League - Improving the quality of in-patient antibiotic prescription in Trauma and Orthopaedics.

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    Open Access article (456.2Kb)
    URI
    http://hdl.handle.net/11287/596961
    Author
    Evans, Jonathan T.
    Saxby, Clair
    Armstrong, Alexander
    Date
    2014-03-25
    Journal
    BMJ quality improvement reports
    Type
    Journal Article
    Publisher
    BMJ
    DOI
    10.1136/bmjquality.u201983.w1831
    Rights
    Archived with thanks to BMJ quality improvement reports. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/http://creativecommons.org/licenses/by-nc/2.0/legalcode
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    Abstract
    A Trust level audit demonstrated that the trauma and orthopaedic department did not reach its own standards in adhering to Trust antibiotic prescribing guidelines. Junior doctors are the main prescribers of antibiotics during inpatient stays. Local policy states that for all inpatients on antibiotics, the start date, duration, and indication for antibiotics must be documented on the drug card. Each patient drug card was reviewed by the department pharmacist and it was recorded whether the documentation was in line with Trust policy. A monthly league table, coined 'The Champions League', was created. It was published monthly and displayed in the doctors' office and other clinical areas to highlight which doctors had or had not adhered to the prescribing guidelines. In August 2012 the monthly audit for the trauma and orthopaedic department included 74 patients. The total number of antibiotic courses prescribed was 28; of these courses only 15 (53.5%) had an indication documented and 15 (53.5%) had a review/stop date documented. In December 2012, after two published league tables, 61 patients were reviewed. A total of 19 antibiotic courses were prescribed; 18 (94.7%) had the indication documented and 16 (84.2%) had the review/stop date documented. The standards of prescribing improved within the department and good prescribing practice became ingrained into each doctor's practice. The league table proved to be a novel tool that helped to raise the profile of antibiotic prescribing and change doctor prescribing habits. It created a competitive spirit within the department which improved morale. Doctors responded positively to feedback if they were not achieving the desirable standards, and enjoyed the challenge of improving the standard of prescribing.
    Citation
    The Champions League - Improving the quality of in-patient antibiotic prescription in Trauma and Orthopaedics. 2014, 3 (1): BMJ Qual Improv Rep
    Publisher URL
    http://dx.doi.org/10.1136/bmjquality.u201983.w1831
    Note
    This article is freely available via Open Access. Click on the 'Additional Link' above to access the full-text from the publisher's website.
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    • 2014 RD&E publications
    • General Trauma & Orthopaedics

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