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Understanding Antimicrobial Prescribing – Can we replace manual surveys with eMeds data?

A 2019/2020 Summer Studentship research project

The antimicrobial point prevalence survey is an essential tool to guide work to reduce the unnecessary use of antimicrobials. Review of the appropriateness of prescribing will help guide quality improvement initiatives and determine a priority list for action to improve the use of antimicrobials. Developing ways of doing this using electronic medicines data may enable more efficient approaches in antimicrobial stewardship.

Student: Sam Cody'mandell
Supervisors: Dr Heather Isenman, Associate Professor Matt Doogue, Dr Sharon Gardiner, Dr Sarah Metcalft
Sponsor: Canterbury District Health Board, Department of Clinical Pharmacology

Introduction

Antimicrobial resistance is a major threat to human health, and is a growing problem in New Zealand as well as overseas. To help slow this problem, hospitals must ensure that antimicrobials are being used appropriately and only when needed. Point prevalence studies are the global standard. A point prevalence study was done at CDHB in 2017 using a paper auditing method of individual patients. Replacing the existing labour intensive method with electronic prescribing and administration (ePA) system derived data may reduce costs and save time. Further these data may be used for other aspects of antimicrobial stewardship.

Aim

To quantify and describe antimicrobial use in hospital using ePA data. To compare ePA derived antimicrobial data with data obtained in a point prevalence study.
Secondary aim: To develop antimicrobial stewardship tools using ePA data.

Method

Data on antimicrobial use will be obtained from the CDHB ePA system for the same dates as the most recent point prevalence study at Christchurch Hospital in 2017. The ePA data will be analysed using existing point prevalence study methodology. This will be compared with the results of the 2017 point prevalence study. Any difference will be examined by manual review of the records to better understand the strengths and limitations of the ePA data. An electronic dashboard will be developed to automate subsequent data collection and aggregation for antimicrobial stewardship work.

Student researcher’s component of the study

The student would be required to compare data collected in the manual 2017 point prevalence survey with medchart derived data to ensure the accuracy of the medchart derived data. This would be done using electronic records and the existing excel data set from the 2017 point prevalence survey. Basic competency in excel essential - the student will be closely supervised however in case of any issues.

Student Prerequisites

Ideally a medical or pharmacy student with an interest in antimicrobials and a keen eye for detail.

How to apply

Email heather.isenman@cdhb.health.nz