Kieran S Hand1,2, Debbie Cumming3, Susan Hopkins4, Sean Ewings5, Andy Fox1,2, Sandya Theminimulle6, Robert J Porter7, Natalie Parker8, Joanne Munns9, Adel Sheikh10, Taryn Keyser11, Richard Puleston12. 1. Southampton Pharmacy Research Centre, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK. 2. Faculty of Health Sciences, University of Southampton, Southampton SO17 1BJ, UK. 3. Pharmacy Department, St Mary's Hospital, Parkhurst Road, Newport, Isle of Wight PO31 7QJ, UK. 4. Department of Infectious Diseases & Microbiology, Royal Free London NHS Foundation Trust, Pond St, London NW3 2QG, UK. 5. Southampton Statistical Sciences Research Institute, University of Southampton, University Road, Southampton SO17 1BJ, UK. 6. Microbiology Department, St Mary's Hospital, Parkhurst Road, Newport, Isle of Wight PO31 7QJ, UK. 7. Department of Microbiology, Royal Devon and Exeter NHS Foundation Trust, Church Lane, Heavitree, Exeter EX2 5AD, UK. 8. Pharmacy Department, Hampshire Hospitals NHS Foundation Trust, Royal Hampshire County Hospital, Romsey Road, Winchester SO22 5DG, UK. 9. Pharmacy Department, Western Sussex Hospitals NHS Foundation Trust, St Richards Hospital, Chichester PO19 6SE, UK. 10. Pharmacy Department, Queen Alexandra Hospital, Southwick Hill Road, Portsmouth Hospitals' NHS Trust, Portsmouth PO6 3LY, UK. 11. Pharmacy Department, Hampshire Hospitals NHS Foundation Trust, Basingstoke and North Hampshire Hospital, Aldermaston Road, Basingstoke RG24 9NA, UK. 12. City Hospital, Institute of Public Health, Nottingham NG5 1PB, UK.
Abstract
Background: The implementation of electronic prescribing and medication administration (EPMA) systems is a priority for hospitals and a potential component of antimicrobial stewardship (AMS). Objectives: To identify software features within EPMA systems that could potentially facilitate AMS and to survey practising UK infection specialist healthcare professionals in order to assign priority to these software features. Methods: A questionnaire was developed using nominal group technique and transmitted via email links through professional networks. The questionnaire collected demographic data, information on priority areas and anticipated impact of EPMA. Responses from different respondent groups were compared using the Mann-Whitney U -test. Results: Responses were received from 164 individuals (142 analysable). Respondents were predominantly specialist infection pharmacists (48%) or medical microbiologists (37%). Of the pharmacists, 59% had experience of EPMA in their hospitals compared with 35% of microbiologists. Pharmacists assigned higher priority to indication prompt ( P < 0.001), allergy checker ( P = 0.003), treatment protocols ( P = 0.003), drug-indication mismatch alerts ( P = 0.031) and prolonged course alerts ( P = 0.041) and lower priority to a dose checker for adults ( P = 0.02) and an interaction checker ( P < 0.05) than microbiologists. A 'soft stop' functionality was rated essential or high priority by 89% of respondents. Potential EPMA software features were expected to have the greatest impact on stewardship, treatment efficacy and patient safety outcomes with lowest impact on Clostridium difficile infection, antimicrobial resistance and drug expenditure. Conclusions: The survey demonstrates key differences in health professionals' opinions of potential healthcare benefits of EPMA, but a consensus of anticipated positive impact on patient safety and AMS.
Background: The implementation of electronic prescribing and medication administration (EPMA) systems is a priority for hospitals and a potential component of antimicrobial stewardship (AMS). Objectives: To identify software features within EPMA systems that could potentially facilitate AMS and to survey practising UK infection specialist healthcare professionals in order to assign priority to these software features. Methods: A questionnaire was developed using nominal group technique and transmitted via email links through professional networks. The questionnaire collected demographic data, information on priority areas and anticipated impact of EPMA. Responses from different respondent groups were compared using the Mann-Whitney U -test. Results: Responses were received from 164 individuals (142 analysable). Respondents were predominantly specialist infection pharmacists (48%) or medical microbiologists (37%). Of the pharmacists, 59% had experience of EPMA in their hospitals compared with 35% of microbiologists. Pharmacists assigned higher priority to indication prompt ( P < 0.001), allergy checker ( P = 0.003), treatment protocols ( P = 0.003), drug-indication mismatch alerts ( P = 0.031) and prolonged course alerts ( P = 0.041) and lower priority to a dose checker for adults ( P = 0.02) and an interaction checker ( P < 0.05) than microbiologists. A 'soft stop' functionality was rated essential or high priority by 89% of respondents. Potential EPMA software features were expected to have the greatest impact on stewardship, treatment efficacy and patient safety outcomes with lowest impact on Clostridium difficile infection, antimicrobial resistance and drug expenditure. Conclusions: The survey demonstrates key differences in health professionals' opinions of potential healthcare benefits of EPMA, but a consensus of anticipated positive impact on patient safety and AMS.
Authors: P F Dutey-Magni; M J Gill; D McNulty; G Sohal; A Hayward; L Shallcross; Niall Anderson; Elise Crayton; Gillian Forbes; Arnoupe Jhass; Emma Richardson; Michelle Richardson; Patrick Rockenschaub; Catherine Smith; Elizabeth Sutton; Rosanna Traina; Lou Atkins; Anne Conolly; Spiros Denaxas; Ellen Fragaszy; Rob Horne; Patty Kostkova; Fabiana Lorencatto; Susan Michie; Jennifer Mindell; John Robson; Claire Royston; Carolyn Tarrant; James Thomas; Jonathan West; Haydn Williams; Nadia Elsay; Chris Fuller Journal: JAC Antimicrob Resist Date: 2021-03-04