Browsing by Author "Ashton, Corrine"

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    A Matter of Time: A Survey to Explore the Perceived Time Released Following a Timely Appropriate Intravenous to Oral Switch
    (Microbiology Society, 2023-11-14) Jenkins, Abi; Hamilton, Ryan A.; Gilani, Syed; Ashton, Corrine; Rushton, Charlotte; Hussain, Sadiya; Williams, Nathan; Razaq, Shahzad; Jamieson, Conor
    Introduction: Optimising timely appropriate intravenous to oral switch (TAIVOS) delivers clinical and operational benefits, as intravenous administration is associated with risk and delays to discharge. One underappreciated issue is the nursing workforce impact due to the increased time required to prepare and administer intravenous compared to oral medicines, at 20 minutes more per dose. Improving awareness of the workforce benefits of TAIVOS could be an additional driver to improving rates of TAIVOS. Awareness of these benefits amongst medical and nursing staff is not known therefore we aimed to gauge degree of awareness through a survey Method: A Microsoft Forms survey was developed by a multidisciplinary working group and distributed to patient facing professionals in acute trusts across the Midlands via QR code, hyperlink, and paper copies. Respondents were asked to estimate the amount of time that could be saved by switching a patient from a three times daily intravenous antibiotic to an oral equivalent. Results: 508 responses were received, 489 from nurses and 19 from doctors. The median time considered by nurses to be released following TAIVOS was 30 minutes (IQR 20-30 minutes), whereas doctors perceived this to be 60 minutes (IQR 20-60 minutes). The scenario provided to the respondent would have equated to a time saving of around 60 minutes. Conclusion: There is considerable underestimation of the time required to prepare and administer intravenous medicines, particularly with nursing staff. Further work is required to increase awareness of the benefit of TAIVOS for workforce capacity across the Midlands and beyond.
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    Don’t be unAWaRe – issues of selected ‘watch’ antibiotics on FP10 prescriptions from Midlands hospitals
    (Microbiology Society, 2023-11-14) Jenkins, Abi; Brush, Andrew; Hamilton, Ryan A.; Gilani, Syed; Ashton, Corrine; Badyal, Karamjit; Begum, Gulshada; Clarkson, Annette; Hussain, Sadiya; Kang, Parmjit; Kay, Rachel; Lehal, Kayleigh; Shah, Kameron
    The World Health Organization emphasises key antibiotics to safeguard through its ‘AWaRe’ classifications. NHS England has adapted these and requires a 10% reduction in use of ‘watch’ and ‘reserve’ agents in English hospitals by March 2024. Antibiotics may be prescribed in hospital using FP10 (green) prescriptions for convenient community dispensing. However, this bypasses review by hospital pharmacists who typically benefit from better access to relevant clinical information and prescribers than community colleagues. The extent to which this happens is unclear, so this project aimed to quantify FP10 issues for the three most common oral ‘watch’ antibiotics at all Midland NHS hospitals. Consumption data in defined daily doses (DDD) for co-amoxiclav, clarithromycin and ciprofloxacin for the period 01/12/2022 to 31/05/2023 was available on Rx-Info’s ‘Define’ platform. Permission to use this was sought from Midlands antimicrobial pharmacists representing 23 Trusts. Eleven consented and data was extracted for analysis in Microsoft Excel. FP10 issues from eleven participating Trusts accounted for 33548 of 674969 DDDs (5%) for co-amoxiclav, 21924 of 224937 DDDs (9.7%) for clarithromycin and 8862 of 157000 DDDs (5.6%) or ciprofloxacin. Trust median proportions deviated slightly at 1.9%, 5.2% and 3% respectively with considerable variation evident (respective IQRs 1.5-11, 3.2-13.7, 1.1-13). Regionally, FP10s represent a substantial portion of the total oral consumption of these agents. High variation likely reflects operational differences in medication supply mechanisms. As FP10s bypass many secondary-care antimicrobial stewardship approaches optimisation could be significant in delivery of NHS standard contract obligations and in slowing development of antimicrobial resistance.
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    Don’t be unAWaRe – Supply of selected ‘watch’ antibiotic pre-packs in Midlands hospitals
    (Microbiology Society, 2023-11-14) Jenkins, Abi; Brush, Andrew; Hamilton, Ryan A.; Gilani, Syed; Ashton, Corrine; Badyal, Karamjit; Begum, Gulshada; Clarkson, Annette; Hussain, Sadiya; Kang, Parmjit; Kay, Rachel; Lehal, Kayleigh; Shah, Kameron
    The UK 5-year national action plan on antimicrobial resistance aims to reduce broad spectrum (WHO Watch and Reserve categories) antimicrobial use in English hospitals by 10% by March 2024. Pre-packs are products prepared with template labels to allow legal supply directly from clinical areas – bypassing pharmacy. Pre-packs are typically used to expedite discharge out of hours and on high turnover wards. However, this often circumvents pharmacists’ medicines and AMS checks – and the contribution of prepacks to overall antimicrobial supply is poorly explored. We aimed to quantify consumption of the three most common ‘watch’ antibiotic pre-packs at Midlands NHS hospitals. Midland antimicrobial pharmacists representing 23 Trusts were invited to contribute. Twelve Trusts provided consumption data for oral formulations of co-amoxiclav, clarithromycin and ciprofloxacin in defined daily doses (DDD) for the period 01/12/2022 to 31/05/2023. Data were collated and analysed in Microsoft Excel. Prepack use from participating Trusts accounted for 198521 of 738492 DDDs (26.9%) for co-amoxiclav, 21118 of 256298 DDDs (8.2%) for clarithromycin and 23479 of 184064 (12.8%) for ciprofloxacin. Trust median proportions were similar at 25%, 6.6% and 11% respectively but with considerable variation (respective IQRs 15.5-32.6, 5.6-9.5, 6.2-16.5). High variation likely reflects operational differences between organisations. Interventions into pre-pack use may support hospitals meeting the 10% reduction in broad-spectrum antibiotics. Research is needed to fully understand whether prepacks are used appropriately in terms of choice, and whether they contribute to extended durations of therapy.
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    Jabs to tabs goes global: point-prevalence of doses of intravenous antibiotic administered as a function of daily census
    (ECCMID, 2024-04) Jenkins, Abi; Gilani, S.; Ashton, Corrine; Hamilton, Ryan A.; Hussain, S.; Hughes, Stephen; Khadern, T.; Yakemowicz, C.; Pogue, J.; McCreary, E.