OBJECTIVES: To develop and test a set of process measures of quality of care in the reassessment of inpatient empirical antibiotic prescriptions, to determine the inter-rater reliability of medical notes' review in assessment of these measures and to test these measures on one ward. METHODS: Measures of process of care were identified from a literature review. Forty sets of medical notes were reviewed by two independent doctors and the inter-rater reliability determined using observed percentage agreement and the kappa statistic. These measures were collected weekly and fed back to doctors in order to stimulate improvement. RESULTS: Four process measures were identified and were grouped together to create a 'day 3 bundle': antibiotic plan, review of the diagnosis, adaptation to microbiology and intravenous-oral switch. The inter-rater agreement was > or = 80% for all measures. Data collection was feasible and was easily sustained over several weeks. The reassessment of antibiotic prescriptions around day 3 was better documented using real-time feedback of the measures to the medical team. CONCLUSIONS: Our measures of care are suitable for the reassessment of empirical inpatient antibiotic prescriptions, with good inter-rater reliability. This quality intervention should be part of a more comprehensive and multifaceted plan to improve antibiotic use in hospitals.
OBJECTIVES: To develop and test a set of process measures of quality of care in the reassessment of inpatient empirical antibiotic prescriptions, to determine the inter-rater reliability of medical notes' review in assessment of these measures and to test these measures on one ward. METHODS: Measures of process of care were identified from a literature review. Forty sets of medical notes were reviewed by two independent doctors and the inter-rater reliability determined using observed percentage agreement and the kappa statistic. These measures were collected weekly and fed back to doctors in order to stimulate improvement. RESULTS: Four process measures were identified and were grouped together to create a 'day 3 bundle': antibiotic plan, review of the diagnosis, adaptation to microbiology and intravenous-oral switch. The inter-rater agreement was > or = 80% for all measures. Data collection was feasible and was easily sustained over several weeks. The reassessment of antibiotic prescriptions around day 3 was better documented using real-time feedback of the measures to the medical team. CONCLUSIONS: Our measures of care are suitable for the reassessment of empirical inpatient antibiotic prescriptions, with good inter-rater reliability. This quality intervention should be part of a more comprehensive and multifaceted plan to improve antibiotic use in hospitals.
Authors: K Kaier; C Wilson; M Hulscher; H Wollersheim; A Huis; M Borg; E Scicluna; M-L Lambert; M Palomar; E Tacconelli; G De Angelis; M Schumacher; M Wolkewitz; E-M Kleissle; U Frank Journal: Infection Date: 2011-08-30 Impact factor: 3.553
Authors: K de With; F Allerberger; S Amann; P Apfalter; H-R Brodt; T Eckmanns; M Fellhauer; H K Geiss; O Janata; R Krause; S Lemmen; E Meyer; H Mittermayer; U Porsche; E Presterl; S Reuter; B Sinha; R Strauß; A Wechsler-Fördös; C Wenisch; W V Kern Journal: Infection Date: 2016-06 Impact factor: 3.553
Authors: C Vercheval; M Gillet; N Maes; A Albert; F Frippiat; P Damas; T Van Hees Journal: Eur J Clin Microbiol Infect Dis Date: 2016-06-02 Impact factor: 3.267
Authors: Peter Davey; Charis A Marwick; Claire L Scott; Esmita Charani; Kirsty McNeil; Erwin Brown; Ian M Gould; Craig R Ramsay; Susan Michie Journal: Cochrane Database Syst Rev Date: 2017-02-09
Authors: Anthony J Guarascio; Douglas Slain; Richard McKnight; Karen Petros; John Parker; Alison Wilson; Carrie M Defazio; Arif R Sarwari Journal: Int J Clin Pharm Date: 2012-10-26