1. Medicine management technicians (MMTs): an untapped resource for antimicrobial stewardship? Samantha Saunders, Lindsay Parsler, Sarah Holmes, Danielle Van-der-Walt, Naomi Fleming Abstract 25
Background: Antibiotic prescribing in England increased by 6% from 2010 to 2013 leading to a CQUIN in 2016/2017 that aimed to look at consumption of antibiotics and make improvement to reduce inappropriate and/ or over usage of antibiotics by appropriate antibiotic review within 72 hours in order to decrease the spread of antimicrobial resistance and improve antibiotic stewardship.
Objectives:
To ensure robust prospective data collection for empiric review of antibiotic prescriptions within 72 hours by training MMTs.
Methods: A spreadsheet was developed to enable technicians to collect accurate and comparable data across a variety of hospital areas. Stickers were developed for the patients notes to encourage antibiotic review.
Training was given by the antibiotic pharmacist in a classroom setting with examples and then on the wards with MMTs until confident.
MMTs were delegated different hospital areas; they inspected every chart in their area to identify patients prescribed antibiotics. Once identified, the duration they had been on antibiotics was logged and the notes inspected to assess whether a review had been undertaken within 72 hours and the results of that review. If the antibiotic was recently started, a sticker was put in the patients’ notes to highlight the need for a review and the patient flagged for follow up to ensure completed.
Results: Results of empiric review in 72 hours increased from 61% quarter 1 to 91% quarter 4.
MMTs collecting data:
completed antibiotic stewardship course on electronic Learning for Health.
developed a rapport with ward staff and improved ward awareness of antimicrobial stewardship and CQUIN.
are advocates of antimicrobial stewardship and are empowered to suggest interventions, particularly review to clinical teams on the ward.
suggested antimicrobial technician ward standards are developed and implemented.
refer patients and signpost clinical teams to the antibiotic pharmacist.
have identified further antimicrobial training needs including therapeutic drug monitoring.
have organised ward based training for clinical teams by the antimicrobial pharmacist.
have instigated addition of antimicrobial indicators to the Prescribing Policy Audit
Conclusions: What started out as a way to capture CQUIN data in a robust manner has resulted in more than an improvement in the number of antibiotics reviewed in 72 hours. Importantly, MMTs have become more knowledgeable, engaged and empowered, enhancing their awareness of and participation in antibiotic stewardship across the trust, communicating with the multidisciplinary team to improve patient care.
References NHS England Antimicrobial Resistance CQUIN: