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Skip to 0 minutes and 4 seconds Hello. In this video, we continue to look at the AACTT framework, content for the slide set that has been provided by Professor Jill Francis from University of Melbourne. Within this slide, the correct answers to the task in the previous step are highlighted below. The correct answers are points 3, 5, and 6. Point 3. Take a haemoglobin reading within 24 hours before transfusing a medical patient. This specifies an action, take a haemoglobin, target, the medical patient, and timing, within 24 hours before transfusing. Context is implied, the medical wards, and the actor is not specified. Point 5. To GPs about their patients with type 2 diabetes, provide personalised advice on physical activity.

Skip to 0 minutes and 52 seconds This specifies an action, provide personalised advice, a target, patient with type 2 diabetes, and an actor, GPs. Context is implied, general practise, and timing is not specified. Point 6. To GPs, if prescribing a traditional oral NSAID in patients aged 75 or over, co-prescribe a gastroprotective drug. This specifies an action, co-prescribe a gastroprotective drug, a target, patients aged 75 and over who are prescribed an oral NSAID, and an actor, GPs. Context is implied, general practise, and timing is implied, when prescribing the NSAID, but could also include the likely need for medication review to identify target patients who have not been prescribed a gastroprotective drug. The other points were not correct as they did not specify an action.

Skip to 1 minute and 47 seconds We will now consider point 7 in more detail.

Skip to 1 minute and 52 seconds Even with AACTT, you may get some behaviours that are so general as to be unactionable. In this example, what additional data do you need to make this behaviour actionable? What action is involved in performing a clinical review? Referring for tests, talking to the patient, calling in a consultant, looking at the patient’s chart. While the meaning may be clear to a physician, it may not be clear to the people who need to know. For example, the nurse who is monitoring the news score. Who is the actor? Does the actor need to be a doctor? If so, is it the nearest available doctor who may be junior, or does the action need to be escalated to a specific level of experience?

Skip to 2 minutes and 32 seconds Is the actor the same night or at the weekends as during weekdays? Clear actions should be laid out. What is urgent? Within a minute or an hour or a day? When does the clock start ticking? From when the news was recorded, or from when the call is made to the actor? Once again, this needs to be specified to provide clear actions.

Skip to 2 minutes and 56 seconds This slide summarises data from analysis of five documents that provided feedback about compliance with four standards for transfusion of blood products. Target patients were always specified, but the action was only specified in 50% of the documents, and the actor was never specified. These papers highlight the need for clearly specified actions and actors so individuals know who is performing what tasks.

Task: Is the action clearly specified?

In this video, the three statements that specify tasks are revealed.

The seventh statement requires further analysis, as it takes more factors into consideration.

Lastly, data is presented from an analysis of five documents that provided feedback about compliance with four standards for transfusion of blood products as an example of how a feedback document can display incomplete AACTT specification.

Please find a downloadable PDF of the PowerPoint slides below.


After watching the video, please read the following question and share your comments below:

Did you guess the three statements that follow the AACTT specification?

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Utilising Social Science and Behaviour Change in Antimicrobial Stewardship Programmes: Improving Healthcare

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