2259 Assessing antibiotic usage on a geriatric ward

Abstract Introduction The World Health Organisation lists antibiotic resistance as one of the biggest threats to global health 1. We contribute to this as clinicians, through errors such as delayed review of prescriptions or prescribing against local trust guidelines. Method We have carried out a quality improvement project to improve antibiotic prescriptions on a geriatric ward at Croydon University Hospital. We carried out a fortnightly cross-sectional analysis of the antibiotic prescriptions on a geriatric ward. This included looking at the antibiotic prescribed, indication, duration, route of administration and presence of a review date. These were then compared to trust guidelines. After the first 8-weeks, we delivered a departmental teaching session on antibiotic prescriptions. We then re-audited the prescriptions. Following this, we sent out weekly email reminders on locating trust guidelines and information on prescriptions. We then re-audited following this. Finally, we created an e-learning resource to deliver to the ward on antibiotic prescriptions. We are planning to deliver this to the ward and re-audit afterwards. Results Initially, up to 90.0% of prescriptions differed from trust guidelines. Common reasons for differences when compared included incorrect drug prescribed, incorrect frequency of dosing, or non-specific indications leading to difficulty comparing. Following all interventions, approximately 32% of prescriptions differed from trust guidelines. This showed sustained improvement across 2 complete PDSA cycles (plan, do, study, act). A 3rd PDSA cycle is ongoing at present and preliminary data has shown approximately 28% of prescriptions differed from trust guidelines. Conclusion This quality improvement project has successfully contributed to a reduction in prescription errors and safe prescribing. We will continue to provide information to our colleagues on antibiotic stewardship, to further encourage safe prescribing. 1. Antibiotic resistance (2020) World Health Organisation. Available at: https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance (Accessed: May 2023).