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Abstract PD-018: PRAISING KIDS - SUPPORTING PICU ANTIMICROBIAL STEWARDSHIP ON A REGIONAL RETRIEVAL SERVICE

Gyles, A.1; Webb, J.1

Pediatric Critical Care Medicine: June 2018 - Volume 19 - Issue 6S - p 35
doi: 10.1097/01.pcc.0000537420.05794.e2
Poster Discussion Abstracts
Free

1Birmingham Women’s and Children’s Hospital NHS FT, KiDS/NTS, Birmingham, United Kingdom

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Aims & Objectives:

To improve the documentation of antimicrobial administration by a retrieval team to support stewardship on the Paediatric Intensive Care Unit (PICU).

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Methods

KIDS/NTS is a regionalized, paediatric and neonatal intensive care retrieval service based at Birmingham Children’s Hospital (BCH) in the UK Midlands, transporting around 1,800 babies/children annually.

BCH recently implemented the PRAISE project (Positive Reporting and Appreciative Inquiry in Sepsis) to improve documentation of initiation of new antimicrobial therapies by using a colourful sticker on the bedside observation chart and a system of positive incident reporting to feedback to practitioners when documentation was of the expected standard.

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Results

A retrospective analysis of 2 months of notes from KIDS (paediatric team) transport episodes (n=73) found that antimicrobial therapy was indicated in 91.8% of cases, however, in 54.8% of notes documentation of antimicrobial therapy was either missing or ambiguous. There was no consistency in where it was documented with 54.8% in patient history and 46.6% in assessment.

To improve documentation a sticker (Figure 1.), adapted from the one used in BCH PICU, was added to all KIDS notes. A review of the first month’s notes from KIDS (paediatric team) transport episodes (n=53) following the initiative found that antimicrobial therapy was indicated in 84.9% of cases. The sticker was completed in 28.9% cases and antimicrobial therapy clearly documented in the history/assessment notes in 66.7%.

Figure

Figure

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Conclusions

For the receiving PICU to be able to effectively steward antimicrobial therapy, accurate and easy to find documentation of previous therapies needs to be provided by the transport team.

©2018The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies