Sahota Ramandeep Singh, Rajan Kiran Kasper, Comont Jonathan Mark Sabine, Lee Hyungeun Hans, Johnston Nikolina, James Mary, Patel Rakhee, Nariculam Joseph
Medical School, GKT School of Medicine, London, UK
Medical School, GKT School of Medicine, London, UK.
BMJ Open Qual. 2020 Feb;9(1). doi: 10.1136/bmjoq-2019-000805.
Antimicrobial resistance is a growing problem worldwide. Encouraging antimicrobial stewardship can help to reduce the negative consequences of inappropriate antibiotic use. This quality improvement project targets to do this by aiming to improve the proportion of 48-hour antimicrobial reviews completed and documented on two surgical wards at Darent Valley Hospital with a goal of 100% compliance.This project used four PDSA (plan, do, study, act) cycles to achieve our aim: a trust-wide email; education sessions with junior doctors; sticker reminders in patient notes; presenting our study to surgical consultants and displaying posters on the wards.The proportion of antimicrobial reviews completed at 48 hours in the patient notes increased from 18% to 77% over 19 weeks from 10 October 2018 to 20 February 2019. The most successful intervention was providing a presentation for consultants at an audit meeting in conjunction with displaying posters on the wards.The most successful interventions (education sessions with junior doctors and presentation to surgical consultants alongside displaying posters on the wards) were found to be those that required minimal further input after their initial rollout. This project was carried out by medical students and is highly transferrable to other hospitals, and highlighted that a successful quality improvement project can be undertaken by any member of the healthcare team.
抗菌药物耐药性是一个在全球范围内日益严重的问题。鼓励抗菌药物管理有助于减少不适当使用抗生素带来的负面影响。这个质量改进项目旨在通过提高达伦特谷医院两个外科病房完成并记录的48小时抗菌药物评估比例来实现这一目标，目标是达到100%的合规率。该项目使用了四个PDSA（计划、执行、研究、行动）循环来实现我们的目标：全信托范围的电子邮件；对初级医生的教育课程；在患者病历中张贴提醒贴纸；向外科顾问展示我们的研究并在病房张贴海报。从2018年10月10日至2019年2月20日的19周内，患者病历中在48小时内完成的抗菌药物评估比例从18%提高到了77%。最成功的干预措施是在一次审计会议上为顾问们进行展示，并在病房张贴海报。最成功的干预措施（对初级医生的教育课程以及在病房张贴海报的同时向外科顾问展示）被发现是那些在最初推出后只需最少进一步投入的措施。这个项目是由医学生开展的，并且很容易推广到其他医院，它还强调了医疗团队的任何成员都可以开展一个成功的质量改进项目。
