HPE HPE 85 – Spring 2017 - Page 36

Pharmacy practice service models to meet the needs of the organisation, the Pharmacy team also seek innovative ways to help meet national agenda. Antimicrobial resistance has been high on the national agenda for a number of years. The phenomena have attracted comment from world leaders, international health organisations and prompted the Chief Medical Officer in England to write a children’s book – ‘The Drugs don’t Work’ – a tale set in a future world without antibiotics. At a local level, across the UK and overseas, antimicrobial pharmacists have been developing strategies to prevent the development of resistance. Such strategies involve conserving current antibiotics through stewardship programmes. Significant amounts of money have been centrally allocated in the UK to improve antimicrobial stewardship in primary and secondary care. 34 Using technology to adhere to national targets At Moorfields, much of the national guidance and and associated CQUINs (commissioning for quality and innovation) relating to antimicrobial stewardship does not conveniently fit the model of care provided. The majority of patients who access services at Moorfields are treated as day case procedures. Nevertheless, as a large user of a specific group of antimicrobials, it is important that stewardship is not ‘just on the radar’ but a central focus of prescribing. To this end, Moorfields has enlisted the services of MicroGuide, a platform with which many Trusts in the UK will already be familiar. MicroGuide is a medical app that can be downloaded on a smartphone. Once downloaded, the user has access to their trust antimicrobial guidelines. The benefits of having instant, free access to the most current guidelines cannot be overstated. This is particularly true for inexperienced prescribers, but also for seniors seeing less routine conditions. The alternative is to attempt to find guidance online, via cumbersome intranets or through out of date paper copies, if available. Time spent searching for guidance can be more effectively used with the patient. Using an app to obtain guidance ensures that recommendations are both up to date and specific to the host organisation. Many trusts make different recommendations for the same condition, taking into account local sensitivity data. hospitalpharmacyeurope.com Key points • Introducing new ideas and technologies is a good mechanism to involve organisational leaders to drive improvement in practice. • Collaborative work is the key to innovation. • It is important to review processes and learn from ways of working in other (non- pharmacy) departments and within other National Health Service (NHS) organisations, as well as non-NHS and non-public organisations • Education and training is key to ensure improved services. • App technology is useful in disseminating guidelines to front-line staff to aid decision making. Challenges in implementing novel solutions Many of the trusts that have uploaded antimicrobial guidelines are general hospitals. Moorfields is one of the first single speciality trusts to make antimicrobial guidance available on an app. This has presented challenges and opportunities. The Moorfields antimicrobial guidelines are the most comprehensive set of recommendations of their type produced by a UK hospital for ophthalmology. The antimicrobial guidelines are developed by senior consultants from each of the subspecialties and are edited by the antimicrobial pharmacist. The guidelines are updated regularly and reviewed by a consultant microbiologist. For many of the conditions in the Moorfields guideline there are no national guidelines available. Adapting the guidelines for use in an ophthalmic specialty meant that the usual classification of body systems, for example, respiratory, GI, etc, had to be abandoned a ́Ս́ɹ)ɕѥьѼɕѕ)!ݕٕȰѼɽ͔)ѡՉ䁵)٥ѥͥ)مՅѥѕ)Mչѡȁ͔)́ɅȵѼ)ɽѥ她хЁɽ%)ɑȁѼɽєѡ͔́)͔ѕ́ٔɕѕ)ٕ́ٔɝ͕Ё)ͥѡ́ѡЁѡ͔ݡո)ѥɽѕ݅ɑ͡ɽɅ)͕܁ѥ́ѡѥɽ)ե́ɔݹ͕)ݥչѡɔ݅́٥)͔ɽɽ́ѡU,́ݕ)ѕɹѥ䰁ՑɅ)役ѡɅ15ə)ՈQЁѥɽͅф)ѡՅѕȁݥչ͡ݕ)ݹ݅ɐɕյѥ)%ѥՑ̰ɥѥɽ)ɕ͍ɥݥѠѥɽե)ͅɕ́Ս́͡ݕ)ȁɽٕЁݥѡչ)ѡ!٥͕ȁٕ䁥)ɽȁᅵɕѽ́ͼ)̰́́)ѡ՝ѡɕͽ́ȁѡ͔)ɽٕ́ѥɽ)ѕ݅ɑ͡ɔձѥѽɥѡ)ɕ͕́Ёх䁅)хЁɕͽ) ͥ) 䁅她ɽЁɅѕɽ)ѥՅɕ٥ݥѥ٥䰁)́ݽɭɅѥ́)ѥѕѕѼ)ЁЁѡ͕٥̸)QՍ́ѡ5ɽե)ձѼɔɽ́Ѽ)Ʌєٕѕ́)ɽ٥䁅́ɔ)Qɔ́ѡͥ䁽ݡ)ɕ͍ɥե́م)ѡձѕѥ)ѕ䁥́ЁЁ)ɕ͕)Iɕ(ā]ѕȁ ѕȁɕ٥܁́ȁɔ)ɵ́Ѽ啐9!L̸)Aɴ(ؠؤ齹=$ļ)A(ظܹɵѥɹ)̵ͥ̽ѕȵɕ٥̵ܵȴ)ɔɵ̵Ѽ啐䵹̴)̼ѥ͕ɥܤ(ȁ ѕȁ@ЁɕЁȁѡѵ)!Ѡظ=ɅѥAɽՍѥ٥䁅)əɵ9!Lєх)U݅Ʌѕمɥѥ̸)ܹɜլ̽ձдͽɍȴ)ݽɭ̽ѡɔѥȵمՔѥє)ѕɹɕͽɍ̽Ʌѥ}ɽՍѥ٥}(͕ɥܤ(́5ə́唁!х9!Lչѥ)Qи-܁eȁɽ́mt)ܹə̹̹լ̽ܵȵɽ(͕ɥܤ