6361 Smart antibiotics prescribing for health care workers; a paediatric intensive care unit experience

Objectives To determine if the clinical indication and duration of antibiotics are documented on drug charts in 100% of patients. Review of antibiotics at 48 hours and action plan documented on drug chart and/or in patient notes in 100% of patients. Audit Standards: Start Smart then focus- antimicrobial stewardship toolkit for inpatient care settings as published by the UK Health Security Agency and adopted by University of North Midlands Hospital NHS Trust.¹ Methods 1. Retrospective collation of data from medical prescription charts of patients admitted on the Children's Intensive Care Unit between September and December 2022. Inclusion Criteria: Patients admitted to the Children's Intensive Care Unit at Royal Stoke Hospital within the study timeframe. Patients on antibiotics while on admission. Results 65% of patient in the audit had the indication for intravenous antibiotics documented while 35% did not. 25% of patients had the duration of intravenous antibiotic prescriptions documented on the prescription chart while 50% of these patients did not have antibiotics duration documented on either the prescription chart or PDMS system. 55% of patients had clear documentation of a reason for extension of IV antibiotics duration and 30% of patients did not. Conclusion Some adherence with national standards was observed but with obvious room for improvement.² With SMART and FOCUSED antibiotics prescribing, it is easier to achieve antimicrobial stewardship and reduce the emergence of antibiotics resistance. References https://www.gov.uk/government/publications/antimicrobial-stewardship-start-smart-then-focus/start-smart-then-focus-antimicrobial-stewardship-toolkit-for-inpatient-care-settings Cunney R, Kirrane-Scott M, Rafferty A, et al. 'Start smart': using front-line ownership to improve the quality of empiric antibiotic prescribing in a paediatric hospital BMJ Open Quality 2019;8:e000445. Doi: 10.1136/bmjoq-2018-000445.