Other Antimicrobial Stewardship Resources
Indicators for Quality Use of Medicines The NSW Therapeutic Advisory Group has produced a manual containing a wide range of targeted process indicators to inform and support quality use of medicines practices. The set of indicators which are specific to antibiotic therapy include:
in Australian Hospitals
- Indicator 2.1 Percentage of patients undergoing specified surgical procedures that receive an appropriate prophylactic antibiotic regimen
- Indicator 2.2 Percentage of prescriptions for restricted antibiotics that are concordant with Drug and Therapeutics Committee approved criteria
- Indicator 2.3 Percentage of patients with a toxic or sub-therapeutic aminoglycoside concentration whose dosage has been adjusted or reviewed prior to the next aminoglycoside dose (currently under review)
- Indicator 2.4 Percentage of adult patients with community acquired pneumonia that are assessed using an appropriate validated objective measure of pneumonia severity
- Indicator 2.5 Percentage of patients presenting with community acquired pneumonia that are prescribed guideline concordant antibiotic therapy.
Mobile Applications to Support AMS
The usefulness and prevalence of mobile device applications (‘apps’) to support best practice in healthcare is increasing across a range of clinical areas. Apps to support appropriate antimicrobial prescribing generally do so by improving the accessibility and/or understanding of locally-endorsed guidelines, and some also provide a level of decision-support at the point of care.
The following list of AMS-related mobile apps has been provided for information purposes only, as examples of the types of applications which have been developed within NSW local health districts or by external commercial entities. Note that inclusion of a product within this list does not constitute an endorsement by the CEC. To find out more about these applications, we ask that you please contact the developers directly.
- eASYapp (developed by the eASY Team, based within Northern Sydney Local Health District) A downloadable app described as an all-in-one decision-support and AMS auditing tool. Antimicrobial prescribing advice is provided according to the selection of either an antibiotic or the infectious indication/location, with capacity to customise content based on local restrictions or guideline recommendations. Auditing capacity includes capturing data on AMS interventions and IV-to-oral switch.
- Westmead Acute Surgery (developed by Westmead Hospital, in association with Sydney University) A downloadable app providing algorithm-based advice for the management of the acute surgical patient, including empirical antibiotic advice for relevant infections. Protocols and recommendations are specific to Westmead Hospital only, and development was supported financially via the HETI Medical Education Support Fund.
- MicroGuide™ (developed by University Hospital Southampton NHS Foundation Trust and Horizon Strategic Partners UK) A downloadable, highly-modifiable guideline and information repository app, the core content of which is controlled by individual health service organisations. Used widely across a range of NHS trusts within the UK, with commercial capacity for international clients.
- HNE Quality Use of Medicines (developed by Hunter New England LHD) A web-based mobile app providing point-of-care access to a selection of medication-related Hunter New England LHD guidelines, including management of common infectious conditions and local IV-to-oral switch protocols. Content is developed and maintained via the HNE Quality Use of Medicines Committee.
- Educational Vancomycin Interactive (developed by Illawarra Shoalhaven Local Health District) A web-based (but mobile-device accessible) interactive education module designed to improve the dosing, administration and monitoring of IV vancomycin in adults. This interactive is highly engaging, free to use and is targeted towards doctors, nurses and pharmacists. Available at www.vancomycin.com.au.
Antimicrobial Prescribing Behaviours
HARC Scholarship Research Project
In 2015, a member of the QUAH program team received a Hospitals Alliance for Research Collaboration (HARC) Scholarship to pursue a research project titled Modifying antibiotic prescribing behaviours: exploring innovative antimicrobial stewardship interventions and the science behind their success.
This scholarship provided financial support to attend an international conference and meet with experts at various centres of excellence throughout the UK. A final report has been provided below, including a literature review and discussion of key learnings and recommendations.
Quality Use of Antimicrobials in Intensive Care (QUAIC)
The QUAIC project was created a number of years ago to develop and support the role of antimicrobial stewardship in intensive care settings. In 2012, the QUAIC project was superseded by the establishment of the broader Quality Use of Antimicrobials in Healthcare (QUAH) program. While the QUAIC project is no longer current, links to the original QUAIC resources are available below.
Audit tool to measure appropriate prescribing: