Primary Care Management of Infection Audit Tool User Guide
Contents
1. Infection Type v S a d a 5 E Acute Cough Bronchitis Number of Consultations Percentage Cellulitis Community Acquired Pneumonia Impetigo Other Otitis Media Pharyngitis Sore Throat Tonsillitis Rhinosinusitis 18 July 2012 Scottish Antimicrobial Prescribing Group Primary Care Management of Infection Audit Tool Page1of2 The report can be printed by clicking the Print button on the top left of the screen or closed by clicking the Close Print Preview button on the top right of the screen 8 Exit Audit Tool To close the application click the Exit Audit Tool button July 2012 10 Scottish Antimicrobial Prescribing Group Primary Care Management of Infection Audit Tool Data Collection Form Patient CHI Database ID Patient Age o 4 5 14 15 29 30 44 45 59 60 74 75 Infection Type Antibiotic _ Acute Cough Bronchitis _ No antibiotic prescribed _ Cellulitis _ Amoxicillin Chronic Obstructive Pulmonary Disease Acute Exacerbation Azithroymcin Community Acquired Pneumonia Cefaclor Impetigo Cefalexin Otitis Media Cefradine Cefuroxime Ciprofloxacin Clarithromycin Co amoxiclav Doxycycline Erythromycin Flucloxacillin Metronidazole Nitrofurantoin Phenoxymethylpenicillin Trimethoprim Other Dual Therapy Pharyngitis Sore Throat Tonsillitis Pyelonephritis acute Rhinosinusitis Urinary Tract Infection Uncompli2. default is No Select Indication for Treatment from the drop down menu Select Prescribing Method from the drop down menu Data entry is complete Click Save Record button Screen ready for next consultation When all consultations have been added click Close Data Entry Screen 3 Editing Patient Records During Data Entry A patient record can be edited or deleted during the current data entry session if a mistake is made Edit a Record If an error has been made during data entry then use the Previous Record and Next Record buttons to move between records Edit the data within the record Click Save Record Delete a Record Use the Previous Record and Next Record buttons to navigate to the record you want to delete Click Delete Record button The record has been removed from the database July 2012 Scottish Antimicrobial Prescribing Group 4 Editing Patient Records After Data Entry To edit a patient record click Edit Consultation Data from the Main Menu The following screen will appear Edit Consultation Data Use the scroll bar to locate the Database ID of the patient record to be edited Double click the database ID in this example Database ID 2 The record for patient with Database ID 2 will appear on screen Edit Consultation Data Database ID Consultation Date Prescriber Name elvis Pl Patient Age Antibiotic Duration of Treatment Delayed Presc
3. encountered infections and fits well with the need to provide evidence of clinical audit for revalidation Guidance e Collect data on all consultations for acute infection for a minimum 2 week period e Data can be entered after each consultation at the end of each day or at the end of the data collection period e A paper based form can be downloaded from the SAPG website to allow consultation details to be recorded for entry at a later date e Consultations which do not result in the issue of a prescription for an antibiotic should still be included e Only antibiotics for systemic use should be included e Anti fungals and anti virals should NOT be included e Antibiotics for prophylaxis and treatment of long term infections should NOT be included e When a patient presents with two or more infection sites a separate form should be completed for each infection e When a patient is prescribed a combination of two or more antibiotics select Dual Therapy July 2012 Scottish Antimicrobial Prescribing Group Main Menu When the audit tool is opened the Main Menu appears which includes guidance on inclusion and exclusion criteria From the Main Menu the user can Add a New Prescriber Add Consultation Data Edit Consultation Data Run Reports and Exit the Audit Tool There is also a link to the SAPG website Scottish Antimicrobial Prescribing Group Primary Care Management of Infection Audit Tool Welcome to the national
4. Scottish Antimicrobial Prescribing Group Primary Care Management of Infection Audit Tool User Guide Introduction Welcome to the national audit tool developed by the Scottish Antimicrobial Prescribing Group SAPG for the audit of primary care management of commonly encountered infections The tool is intended to provide prescribers with qualitative information on their prescribing of antibiotics which will complement existing quantitative information available via PRISMS What are the benefits to prescribers from using the audit tool The tool provides reports which are intended to facilitate reflective learning on individual prescribers own patterns of use of antibiotics The reports allow prescribers to compare their own prescribing decisions with local prescribing policy This reflection can support identification of areas for quality improvement The tool can be used by a number of prescribers in the same practice and provides a practice level report in addition to individual prescriber reports With GP revalidation there is a requirement for GPs to undertake clinical audit which should illustrate how the audit has enabled the GP to reflect on their own practice and improve the quality of care As antibiotic prescribing is generally for acute infection it is one of the few prescribing actions that can be easily attributed to an individual prescriber The tool provides a system for the collection and analysis of data on management of commonly
5. biotic Duration of Treatment Delayed Prescription No v prescribing Method O EE a e Note Database ID is an automatically generated number so this field does not have to be completed but should be added to the data collection form to enable prescribers to review the individual patient record as part of the process of reflection at the end of the audit e Add Consultation Date using the date picker e Select Prescriber Name from the drop down menu e Select the Patient s Age group from the drop down menu e Select the Infection Type from the drop down menu a If an antibiotic was not prescribed during the consultation e Select Antibiotic as No antimicrobial prescribed symptomatic relief self care advice Further data fields are removed from the screen as shown below Data entry is complete Click Save Record button Screen ready for next consultation July 2012 Scottish Antimicrobial Prescribing Group Add Consultation Data Database ID Consultation Date 30 June 2012 Prescriber Name doctor v Patient Age 4 Infection Type Acute Cough Bronchitis Antibiotic No antimicrobial prescribed symptomatic relief self care advice ne lw Te b If an antibiotic was prescribed during the consultation Select Antibiotic from the drop down menu If a dual prescription has been issued select Dual Therapy Select Duration of Treatment from the drop down menu Indicate if a Delayed Prescription was issued
6. cated Female Urinary Tract Infection Uncomplicated Male Other UUU EE E e Prescriber Name Consultation Date Duration of Treatment 3 days 5 days _ 7 days 10 days gt 10 days _ Other Delayed Prescription Yes _ No Indication for Treatment _ Empirical treatment first agent used Empirical treatment second or subsequent agent _ Microbiologically confirmed infection first agent used _ Microbiologically confirmed infection second agent used Prescribing Method _ Face to face consultation Telephone request from patient Following receipt of laboratory information July 2012
7. mation will enable prescribers to understand which infections have been treated using higher risk antibiotics This information should be interpreted in the context of local prescribing policies to assess the appropriateness of this prescribing July 2012 Scottish Antimicrobial Prescribing Group 9 7 Printing Reports Reports open in Print Preview mode Access 2003 Access 2007 Scottish Antimicrobial Prescribing Group Primary Care Management of Infection Audit Tool A Prescriber Summary of Consultation1 SAPG Primary Care Audit Tool Database Access 2007 Microsoft Access a eg EC Eile Edit View Tools Window Help Type a question for help f X a m H OQ Show Margins a Q JE Ee cs Ret frp Word j B mo Print Data Only Se 7 Sa _ gt Text File f R tina Period Print Size Portrait Landscap sa Page Zoom Two More Refresh Excel SharePoint PDF ma Close Print Prescriber Consultation Summary aporting Pario EE Columns Setup Page Pages Pages All List or XPS More Preview E Zoom Data Close Preview Prescriber doctor Total Number of Consultations Prescriber Consultation Summary Reporting Period 02 Jan 22 31 Jan 12 Prescriber Andrea Total Number of Consu Itations Numberof Consultations Percentage of Consuit ations Number of Consultations Percentage of Consultations o 4 years 5 14 years 15 29 years 30 44 years 45 59 years 60 74 years 75 years
8. ng Method The information on indication for treatment may be useful in interpretation of compliance with recommendations in local prescribing policies Prescribing of antibiotics following telephone assessment should be limited to exceptional cases b Antibiotics Summary The aim of antibiotic prescribing policies is to provide recommendations for the empirical treatment of commonly encountered infections to promote safe effective and economic use of antibiotics and to minimise the emergence of bacterial resistance The report provides a summary of antibiotic prescribing for all consultations that resulted in the issue of a prescription between the specified Start Date and End Date and includes a breakdown of antibiotic use by Infection Type This information should be interpreted in the context of local prescribing policies to identify areas for quality improvement July 2012 Scottish Antimicrobial Prescribing Group c Antibiotic Duration Summary Prescribing policies usually provide advice on the drug dose and duration for empirical treatment with antibiotics The report provides a summary of antibiotic duration for all consultations that resulted in the issue of a prescription between the specified Start Date and End Date and includes a breakdown of antibiotic duration by Infection Type This information may be useful in interpretation of compliance with recommendations in local prescribing policies d No Prescribing Strategy Uppe
9. r Respiratory Tract Infections ed e f Prescribing guidance advises that antibiotics should only be prescribed when there is likely to be a clear clinical benefit and a no antibiotic strategy should be considered for acute self limiting upper respiratory tract infections The report provides the number and proportion of consultations for upper respiratory tract infections Acute Cough Bronchitis Otitis Media Pharyngitis Sore Throat Tonsillitis and Rhinosinusitis which did not result in a prescription for antibiotics between the specified Start Date and End Date Delayed Prescriptions Upper Respiratory Tract Infections A delayed prescription strategy is recommended as an option for acute self limiting upper respiratory tract infections The report provides a summary of consultations that resulted in a delayed prescription being issued for upper respiratory tract infections Acute Cough Bronchitis Otitis Media Pharyngitis Sore Throat Tonsillitis and Rhinosinusitis between the specified Start Date and End Date Antibiotics with a higher Risk of Clostridium difficile Infection Antibiotic prescribing policies are intended to support a reduction in the use of antibiotics such as co amoxiclav ciprofloxacin and cephalosporins that are associated with a greater increased risk of CDI The report provides a summary of infections treated using agents with a high risk of CDI between the specified Start Date and End Date This infor
10. ription No felt lesteletle jay ips Empirical treatment second or subsequent agent used w Prescribing Method Telephone request from patient z Edit a Record e Edit the record and after changes have been made click Save Edits e The form will close automatically and you will be returned to the Edit Consultation Data Screen Delete a Record e To delete the record click Delete Record button e The form will close automatically and you will be returned to the Edit Consultation Data screen Continue until all edits have been made Click Close to return to the Main Menu July 2012 Scottish Antimicrobial Prescribing Group 5 Run Reports To produce reports click the Run Reports button on the Main Menu The following form will appear Reports Prescriber Level Report he Prescriber Name Consultation Summary Antibiotic Use Summary Antibiotic Duration Summary No Prescribing Strategy URTI Delayed Prescription URTI Antibiotics with a Higher Risk of Clostridium difficile Infection A tabular and graphical version is available for each report by clicking the Tables or Charts button respectively Further information about the reports can be found by clicking the button Reports can be run at a Prescriber Level default To run a prescriber level report e Select Start Date and End Date for the period during which data were collected using
11. the date pickers e Select Prescriber Name e Select the Prescriber Level Report to be run by choosing Tables or Charts b Practice Level To run a practice level report e Uncheck the Prescriber Level Report button The following screen will appear July 2012 Scottish Antimicrobial Prescribing Group Reports oO PrescriberLevel Report 2 Consultation Summary Tables charts Antibiotic Use Summary Tables Charts Antibiotic Duration Summary Tables charts No Prescribing Strategy URTI Charts Delayed Prescription URTI Tables charts Antibiotics with a Higher Tables Risk of Clostridium difficile f Infection e Select the Start Date and End Date for the period during which data were collected using the date picker e Select the Practice Level Report to be run by choosing Tables or Charts When all reports have been run click Close Form to return to the Main Menu 6 Report Types There are six reports available a Consultation Summary The report provides a summary of all consultations relating to acute infection that took place between the specified start date and end date and includes a breakdown of all consultations by Age and Infection Type The report summarises the number of consultations that resulted in the issue of a prescription Consultations that resulted in the issue of a prescription are broken down by Indication for Treatment and Prescribi
12. tool developed by the Scottish Antimicrobial Prescribing Group for the audit of primary care management of commonly encountered infections This audit tool is intended to provide prescribers with qualitative information on their prescribing of antibiotics This information will complement existing quantitative information available via PRISMS It is intended to facilitate reflective learning on use of antibiotics The results will allow prescribers to compare their own prescribing decisions with local prescribing guidance and will support identification of areas for quality improvement O nd heer resotber GR Add Consultation Data Run Reports mr Edit Consultation Data Exit Audit Tool 1 Add New Prescriber Before entering data the prescriber must add their name to the database Click Add New Prescriber button on the Main Menu The following form will appear New Prescriber Form f Save Prescriber Name New Prescriber Name fo Close Form Enter the prescriber s name in the text box Click Save Prescriber Name The form closes automatically To close the form without adding a new prescriber click Close Form July 2012 Scottish Antimicrobial Prescribing Group 2 Add Consultation Data To add data click Add Consultation Data button on the Main Menu The following form will appear Add Consultation Data Database ID AutoNumber Consultation Date C Prescriber Name Patient Age Infection Type Anti
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