Volume 179 - Issue 3
A simple intervention to improve hospital antibiotic prescribing
Authors: Jill S Butty and Saji S Damodaran
Med J Aust 2003; 179 (3): 175-176. || doi: 10.5694/j.1326-5377.2003.tb05486.x
Published online: 4 August 2003
Published online: 4 August 2003
Jill S Butty
Quality Facilitator, Werribee Mercy Hospital, 300 Princes Highway, Werribee, VIC 3030 jbuttyATmercy.com.au
To the Editor: It was refreshing to see the report by South et al, describing a simple, inexpensive intervention which resulted in a positive effect on the appropriate prescribing of antibiotics and a cost saving for the organisation.1
In the current climate, it has been much more fashionable to suggest computerised prescribing as the cure-all for medication and prescribing errors. As demonstrated by Newby et al,2 computerised prescribing has inherent problems, including an increase in repeat ordering of antibiotics.
The Australian Council for Safety and Quality in Healthcare suggests computerised prescribing as one of several strategies to reduce medication critical incidents.3 However, the costs of establishing such a system in smaller hospitals and community health centres can prove prohibitive. This can lead to an attitude of “too expensive” so do nothing.
Other strategies and interventions can be introduced at minimal cost to the organisation and yet prove effective in reducing both inappropriate prescribing and the number of critical incidents or errors. The provision of easily accessible standardised protocols and guidelines, the review of medication charts and their ease of use, changing the times of daily medication administration to maximise access to clinicians, and empowering patients to be more aware and responsible for their medications are just a few.
In summary, other strategies need to be developed and their success or failure reported. There should also be awareness that familiarity with procedures can lead to errors and reinforcement is required for all interventions. Computerised prescribing should not be viewed as the solution to all medication adverse events, but one of several strategies that healthcare organisations can use in their battle with medication errors.
References
- South M, Royle J, Starr M. A simple intervention to improve hospital antibiotic prescribing. Med J Aust 2003; 178: 207-209.
- Newby DA, Fryer JL, Henry DA. Effect of computerised prescribing on use of antibiotics. Med J Aust 2003; 178: 210-213. i1082725
- Australian Council for Safety and Quality in Health Care. Second national report on patient safety. Improving medication safety. Canberra: ACSQHC, 2002. Available at: http://www.safetyandquality.org/ (accessed May 2003).
- South M, Royle J, Starr M. A simple intervention to improve hospital antibiotic prescribing. Med J Aust 2003; 178: 207-209. <eMJA full text>
- Ibrahim JE. Prioritising quality. J Qual Clin Pract 2001; 21: 160-162.
- Macintyre CR, Sindhusake D, Rubin G. Modelling strategies for reducing pharmaceutical costs in hospital. Int J Qual Health Care 2001; 13: 63-69.