Implementation of a quality improvement strategy to optimise the management of community acquired pneumonia in a rural health setting

IF 1.9 4区 医学 Q2 NURSING Australian Journal of Rural Health Pub Date : 2024-04-01 DOI:10.1111/ajr.13116
Carrington Sally B.Pharm, Grad Dip Rural Generalist Practice, Chau Gabrielle B. Pharm, MClinPharm, Miller Waugh Sidony BPharm, GCPharmPrac, Symmons Christopher MBBS, FRACGP, Titmarsh Justin BN, MBBS, FRACGP, DRANCOG (Adv), AFRACMA, Minyon L. Avent B Pharm, BSc (Hons), Pharm D, FSHP, FANZCAP (InfDis, Steward), GradCertHlthSc
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Abstract

Problem

In Australia, inappropriate prescribing of antimicrobials is higher in rural and regional areas than in major city hospitals. Inappropriate prescribing is defined as the prescription of antimicrobial agents that do not adhere to guidelines in terms of type of antimicrobial chosen, dose and/or duration or are deemed unnecessary. A review of antimicrobial prescribing in a Queensland rural Hospital and Health Service (HHS) identified that respiratory infections were an area for potential improvement.

Setting

The study was performed in a rural HHS in Queensland.

Key Measures for Improvement

Appropriateness of antimicrobial prescribing for baseline and post-implementation phases of the study was evaluated according to Therapeutic Guidelines: antibiotic recommendations for community acquired pneumonia (CAP).

Strategies for Change

Quality improvement strategy to implement a multifaceted package of interventions for CAP.

Effects of Change

Post-implementation, overall appropriateness of antimicrobial prescribing improved and there was a decrease in duration of antimicrobial therapy.

Lessons Learnt

A quality improvement strategy to implement a multifaceted package of interventions for CAP has shown to be acceptable and effective in improving the antimicrobial prescribing in a rural setting. Our findings highlight the importance of utilising a multifaceted package of interventions which can be tailored to the prescribers and the patients at hand. It is also valuable to engage with local clinicians to promote the optimal management of common infections in the rural setting.

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实施质量改进战略,优化农村医疗机构对社区获得性肺炎的管理。
问题:在澳大利亚,农村和地区的抗菌药物处方不当率高于大城市医院。不适当处方的定义是,处方中的抗菌剂在所选抗菌剂的类型、剂量和/或持续时间方面不符合指南要求,或者被认为是不必要的。对昆士兰州一家农村医院和卫生服务机构(HHS)的抗菌药处方进行的审查发现,呼吸道感染是一个有可能改进的领域:研究在昆士兰州的一家农村医院和医疗服务机构进行:主要改进措施:根据《治疗指南:社区获得性肺炎(CAP)的抗生素建议》,对基线阶段和研究实施后阶段的抗菌药物处方的适当性进行评估:质量改进战略:针对 CAP 实施多方面的一揽子干预措施:实施后,抗菌药物处方的总体适当性得到改善,抗菌药物治疗的持续时间缩短:针对 CAP 实施多方面一揽子干预措施的质量改进策略在改善农村地区的抗菌药物处方方面显示出了可接受性和有效性。我们的研究结果凸显了利用多层面一揽子干预措施的重要性,这些措施可根据处方者和患者的具体情况量身定制。此外,与当地临床医生合作以促进农村地区常见感染的优化管理也很有价值。
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来源期刊
Australian Journal of Rural Health
Australian Journal of Rural Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
2.30
自引率
16.70%
发文量
122
审稿时长
12 months
期刊介绍: The Australian Journal of Rural Health publishes articles in the field of rural health. It facilitates the formation of interdisciplinary networks, so that rural health professionals can form a cohesive group and work together for the advancement of rural practice, in all health disciplines. The Journal aims to establish a national and international reputation for the quality of its scholarly discourse and its value to rural health professionals. All articles, unless otherwise identified, are peer reviewed by at least two researchers expert in the field of the submitted paper.
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