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Comparison and benchmarking with PPS data

Andrew Seaton discusses using a rolling programme of PPS.
This morning I’m meeting with Dr. Andrew Seaton, who’s the lead clinician for the anti-microbial team in Glasgow and Clyde. Thanks for joining us, Andrew, to discuss how you and your colleagues in Glasgow have used PPS to support improvement in anti-microbial prescribing. So can you give us some details, now, about why you started PPS, and describe how you began to use it on a more regular basis? So in a previous organisational way, we’ve been doing PPS for quite a few years, we’ve had an opportunity to test our methodology and to understand what works and what doesn’t work.
The key thing here is giving us that qualitative data about anti-microbial prescribing that you just don’t get from the quantitative data or the DDDs per thousand of admissions. We wanted to drill down into the quality of prescribing and looking at variation in practice across our sites for similar conditions. Surgical prophylaxis, but for all sorts of acute clinical infections. So we think this give a lot of added value on top of what you get from the quantitative data through defined daily doses. So it sounds like the approach you’ve used in Glasgow and Clyde’s been very useful for targeting quality improvement. Have you got any final thoughts you’d like to share with our learners about the value of PPS?
Well, I think the most important thing from my perspective is that doing regular PPS allows you to understand, to know your organisation, to understand your anti-microbial prescribing practice. And you don’t get a sense of that when you just look at the volume of prescribing. It’s certainly been really helpful to us to allow us to identify areas for improvement, as you’ve said, and to target interventions, and then to go back and look at if our interventions are working, and particularly if they’re sustainable. And finally, I hope it helps one reassure oneself about the improvement measures that you put into place and also allows you to reassess your improvement measures, your practice. This is really a key issue.
Anti-microbial stewardship is a moving field. Prescribing is a moving target, so your information is key, and engagement with your clinicians is absolutely key to make improvements sustained. Thanks very much, Andrew, for sharing your experience. And I’m sure that will help learners to understand how they might be able to put PPS into practice in your local setting. Thanks very much.

It is possible to use a rolling programme of PPS carried out on a monthly or annual basis either in one ward or several wards to monitor quality of prescribing and quickly respond to any issues identified.

The Antimicrobial Team in Glasgow, Scotland, have used this approach over several years and have found it helpful for highlighting problems and implementing stewardship initiatives.

Watch this video as Dr Andrew Seaton, Lead Clinician for Antimicrobial Team in Glasgow, shares his experience of using PPS in this way. Greater Glasgow and Clyde has four acute adult hospitals serving a population of 1.2 million, about a quarter of Scotland’s population.

They are fortunate to have a large antimicrobial stewardship team comprising of Dr Seaton as lead clinician as well as a lead microbiologist, antimicrobial pharmacist and six specialist pharmacists, servicing an inpatient population of 4,000.

In the video Dr Seaton refers to monitoring antibiotic use using Defined Daily Doses (DDDs) – this measure was discussed in Week 1 if you want to refresh your memory.

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Challenges in Antibiotic Resistance: Point Prevalence Surveys

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