1. Antimicrobial Care Bundle
The journey so far
Julie Harris, Antimicrobial Pharmacist

2. Antimicrobial Stickers (Feb 2011)
Acknowledgements to UHW
Antimicrobial Stickers (Feb 2011)

3. Antimicrobial Care Bundle – July 2011
Clear indication for antimicrobial(s) on medication chart
Documentation of stop or review date on medication chart
Consistency with Health Board guidelines
Documentation of allergy status on medication chart
Use of antimicrobial sticker(s)
Antimicrobial Care Bundle – July 2011

4. Monthly ‘spot check’ audits – July 2011
Conducted by ward pharmacists
Check compliance to each element of the care bundle
All acute wards within ABMU audited
Data analysed, monthly report produced and circulated
Monthly ‘spot check’ audits – July 2011

5. The first month’s results
All of the standards (care elements) should be achieved for all patients prescribed antimicrobials
The first month’s results

6. Feedback Extra paperwork Problems locating stickers on ward
A lot of detail required
Takes up two sections on medication chart
Difficult to attach to correct place on medication chart
Reluctance of prescribers
Feedback

7. New Sticker- July 2012

8. Infection Prevention Board- April 2012
Chaired by the Chief Executive / Nurse Director
Meets Monthly
Directorates report quarterly to the board
HCAI infection rates
Care bundle compliance
Training compliance
Infection Prevention Board- April 2012

9. Sustained pressure on the directorates to improve compliance with the antimicrobial bundle
Chief Executive tasking Clinical Directors within each directorate to improve results
Raised profile of antimicrobial prescribing within the organisation
The Result......

14. Outcome Measures?

15. Other problems...

16. Rx > 7 days

17. Proposed changes Capture additional clinical information
Antibiotic
Indication
Route
Day of therapy
Automate the input of the data
Form readers
Link to fundamentals of care database
Proposed changes

19. New format report Focus on clinical aspects of prescribing
High risk antibiotics
Extended durations
Surgical prophylaxis regimens
Highlight areas to directorates that require detailed audit
Each directorate is required to conduct a minimum of 2 antimicrobial-related audits a year
New format report

20. Any Questions / Comments