Identification of targets for quality improvement in antimicrobial prescribing

The web-based ESAC point prevalence survey 2009

ESAC-3 Hospital Care Subproject Group

Research output: Contribution to journalArticle

84 Citations (Scopus)

Abstract

Objectives: Since electronic prescribing is limited to few hospitals, point prevalence surveys, such as the standardized European Surveillance of Antimicrobial Consumption point prevalence survey (ESAC PPS), are an alternative tool for monitoring prescribing and helping to identify performance indicators and prescribing trends. The main objective of this study was to identify and assess targets for quality improvement. Methods: Each hospital had to carry out the survey within 2 weeks. Each department had to be surveyed in 1 day. Data collected, for all inpatients, included age and gender. For patients on systemic antimicrobial treatment, the antimicrobial/s, infection/prophylaxis site, reason in medical notes and guideline compliance were also collected. A central database using a web-based tool (WebPPS) developed in-house was used for data entry. Results: Combination of two or more antimicrobials accounted for 30% of use. Surgical prophylaxis was prolonged (>1 day) in 53% of cases. 'Intensive care' had higher proportions of treated patients (53% versus 29%), combination therapy (49% versus 31%), hospital-acquired infections (49% versus 31%) and parenteral administration (91% versus 61%). 'Reason in notes' was documented in 76%, and 'guideline compliance' occurred in 62% of patients. Conclusions: The ESAC PPS provided useful information on the quality of prescribing, which identified a number of targets for quality improvement. These could apply to specific departments or whole hospitals. Intensive care, which has different characteristics, should not be compared with general wards with respect to combination therapy, hospital-acquired infections or parenteral proportion. The study confirmed that the ESAC PPS methodology can be used on a large number of hospitals at regional, national, continental or global level.

Original languageEnglish
Article numberdkq430
Pages (from-to)443-449
Number of pages7
JournalJournal of Antimicrobial Chemotherapy
Volume66
Issue number2
DOIs
Publication statusPublished - Feb 1 2011

Fingerprint

Quality Improvement
Critical Care
Cross Infection
Compliance
Electronic Prescribing
Guidelines
Patients' Rooms
Inpatients
Therapeutics
Surveys and Questionnaires
Databases
Infection

Keywords

  • Antimicrobial consumption
  • Europe
  • Hospitals
  • Point prevalence surveys

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Identification of targets for quality improvement in antimicrobial prescribing : The web-based ESAC point prevalence survey 2009. / ESAC-3 Hospital Care Subproject Group.

In: Journal of Antimicrobial Chemotherapy, Vol. 66, No. 2, dkq430, 01.02.2011, p. 443-449.

Research output: Contribution to journalArticle

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abstract = "Objectives: Since electronic prescribing is limited to few hospitals, point prevalence surveys, such as the standardized European Surveillance of Antimicrobial Consumption point prevalence survey (ESAC PPS), are an alternative tool for monitoring prescribing and helping to identify performance indicators and prescribing trends. The main objective of this study was to identify and assess targets for quality improvement. Methods: Each hospital had to carry out the survey within 2 weeks. Each department had to be surveyed in 1 day. Data collected, for all inpatients, included age and gender. For patients on systemic antimicrobial treatment, the antimicrobial/s, infection/prophylaxis site, reason in medical notes and guideline compliance were also collected. A central database using a web-based tool (WebPPS) developed in-house was used for data entry. Results: Combination of two or more antimicrobials accounted for 30{\%} of use. Surgical prophylaxis was prolonged (>1 day) in 53{\%} of cases. 'Intensive care' had higher proportions of treated patients (53{\%} versus 29{\%}), combination therapy (49{\%} versus 31{\%}), hospital-acquired infections (49{\%} versus 31{\%}) and parenteral administration (91{\%} versus 61{\%}). 'Reason in notes' was documented in 76{\%}, and 'guideline compliance' occurred in 62{\%} of patients. Conclusions: The ESAC PPS provided useful information on the quality of prescribing, which identified a number of targets for quality improvement. These could apply to specific departments or whole hospitals. Intensive care, which has different characteristics, should not be compared with general wards with respect to combination therapy, hospital-acquired infections or parenteral proportion. The study confirmed that the ESAC PPS methodology can be used on a large number of hospitals at regional, national, continental or global level.",
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author = "{ESAC-3 Hospital Care Subproject Group} and Peter Zarb and Brice Amadeo and Arno Muller and Nico Drapier and Vanessa Vankerckhoven and Peter Davey and Herman Goossens and S. Metz-Gercek and H. Jansens and B. Markova and C. Kontemeniotou and A. Andrasevic and J. Vlcek and N. Frimodt-M{\o}ller and P. Mitt and O. Lyytikainen and X. Bertrand and de, {With K.} and G. Tern{\'a}k and R. Cunney and R. Raz and S. Brusaferro and U. Dumpis and V. Butkyte and B. Marcel and P. Zarb and Haug, {J. B.} and J. Pawlowksa and I. Teixeira and S. Ratchina and M. Cizman and M. Sora and G. Skoog and G. Zanetti and M. Filius and Sardan, {Y. C.} and J. Cooke and H. Webb and P. Davey and M. Heginbothom",
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AU - ESAC-3 Hospital Care Subproject Group

AU - Zarb, Peter

AU - Amadeo, Brice

AU - Muller, Arno

AU - Drapier, Nico

AU - Vankerckhoven, Vanessa

AU - Davey, Peter

AU - Goossens, Herman

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AU - Andrasevic, A.

AU - Vlcek, J.

AU - Frimodt-Møller, N.

AU - Mitt, P.

AU - Lyytikainen, O.

AU - Bertrand, X.

AU - de, With K.

AU - Ternák, G.

AU - Cunney, R.

AU - Raz, R.

AU - Brusaferro, S.

AU - Dumpis, U.

AU - Butkyte, V.

AU - Marcel, B.

AU - Zarb, P.

AU - Haug, J. B.

AU - Pawlowksa, J.

AU - Teixeira, I.

AU - Ratchina, S.

AU - Cizman, M.

AU - Sora, M.

AU - Skoog, G.

AU - Zanetti, G.

AU - Filius, M.

AU - Sardan, Y. C.

AU - Cooke, J.

AU - Webb, H.

AU - Davey, P.

AU - Heginbothom, M.

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N2 - Objectives: Since electronic prescribing is limited to few hospitals, point prevalence surveys, such as the standardized European Surveillance of Antimicrobial Consumption point prevalence survey (ESAC PPS), are an alternative tool for monitoring prescribing and helping to identify performance indicators and prescribing trends. The main objective of this study was to identify and assess targets for quality improvement. Methods: Each hospital had to carry out the survey within 2 weeks. Each department had to be surveyed in 1 day. Data collected, for all inpatients, included age and gender. For patients on systemic antimicrobial treatment, the antimicrobial/s, infection/prophylaxis site, reason in medical notes and guideline compliance were also collected. A central database using a web-based tool (WebPPS) developed in-house was used for data entry. Results: Combination of two or more antimicrobials accounted for 30% of use. Surgical prophylaxis was prolonged (>1 day) in 53% of cases. 'Intensive care' had higher proportions of treated patients (53% versus 29%), combination therapy (49% versus 31%), hospital-acquired infections (49% versus 31%) and parenteral administration (91% versus 61%). 'Reason in notes' was documented in 76%, and 'guideline compliance' occurred in 62% of patients. Conclusions: The ESAC PPS provided useful information on the quality of prescribing, which identified a number of targets for quality improvement. These could apply to specific departments or whole hospitals. Intensive care, which has different characteristics, should not be compared with general wards with respect to combination therapy, hospital-acquired infections or parenteral proportion. The study confirmed that the ESAC PPS methodology can be used on a large number of hospitals at regional, national, continental or global level.

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KW - Antimicrobial consumption

KW - Europe

KW - Hospitals

KW - Point prevalence surveys

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