Poster Discussion Abstracts
Aims & Objectives:
To improve the documentation of antimicrobial administration by a retrieval team to support stewardship on the Paediatric Intensive Care Unit (PICU).
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.
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%.
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.