RPS Conference 2010, Abstracts 2010 - Royal Pharmaceutical Society

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combinations being prescribed. Prospective data analysis from 2009 also reflects these improvements. The following goals are suggested by the audit to improve prescribing and adherence, via an educational programme, improving the prescribing environment and introducing monitoring measures: (1) Improve the use and frequency of the CURB-65 1 (2) Improve prescribers’ knowledge of the guidelines (3) Address the tendency of junior doctors to over-treat CAP patients. Finally measures such as continuous improvement in education, improving the use of technology and planning for re-audit were considered in order to ensure improvement sustainability. References 1. British Thoracic <strong>Society</strong>. Guidelines for the management of community acquired pneumonia in adults: update 2004. [online] http://www.britthoracic.org.uk/Portals/0/Clinical%20Information/Pneumonia/Guidelines/MACAPrevisedApr04.p df (accessed 9 November 2009). 2. Department of Health. The Path of Least Resistance, 1998. [online] http://www.advisorybodies.doh.gov.uk/pub/docs/doh/smacrep.pdf (accessed 10 November 2009). 3. NICE. Principles for best Practice in Clinical Audit, 1 st edn. Oxon:Radcliffe Medical Press Ltd 2002. 4.NICE. Chronic obstructive pulmonary disease: Guideline 12, 2004. [online] http://guidance.nice.org.uk/CG12 (accessed 10 November 2009).
36 A Clinical Audit on Reporting and Documentation of Penicillin Allergy at an NHS Foundation Trust Hospital. Wasan Amin 1 , Geeta Hitch 1 , Shingayi Molai 2 , Imran Khan 2 , Rohinton Mulla 2 1 University of Hertfordshire, Hatfield, United Kingdom, 2 Luton and Dunstable Hospital NHS Foundation Trust, Lewsey Road, Luton, Beds, LU4 0DZ, UK., Luton, United Kingdom Focal points: • The current practice regarding documentation and reporting of penicillin allergy by healthcare professionals (HCPs) and to evaluate whether over-reporting of penicillin allergy was audited by examining prospective and retrospective patient data. • Although the use of an alert card and red/white stickers in patients’ hospital documentation was employed, no formal guidelines on documentation of penicillin allergy were identified as was a significant (p≤0.0001) lack of implementation of these procedures. • No set criteria were identified to enable HCPs to interpret patients’ accounts of self reported penicillin allergy as either IgE- or non IgE-mediated, the latter being an adverse side effect resulting in an over-reporting of penicillin allergy by 10% in 59 cases (p≤0.035). Introduction: Inaccurate documentation of drug allergies can result in patients being given drugs to which they are allergic. The reported incidence of allergic reactions to penicillin ranges from 1% to 10% however, the true incidence of anaphylactic reactions is in the range of 0.004% to 0.015% 1 and patients are labelled as allergic to penicillin without a detailed investigation to the nature of their reaction 2 . Method: An audit was carried out to assess the current practice regarding documentation and reporting of penicillin allergy by HCPs as set out by NICE 3 . Retrospective data (n=100) were analysed and significant differences between current practice and set standards for this study were evaluated. Data from patients’ medical notes and drug charts (n=100) were examined to ascertain the completeness of the information. As there was no documentation defining differences between a true allergic reaction and a side effect, criteria were established to identify IgEand non-IgE-mediated responses. Records were also examined to establish existing antibiotic policy recommendations. Pre-piloted questionnaires were distributed to both patients (n=100) and HCPs (n=30) for their perceptions and knowledge regarding allergic reactions. Ethics approval was granted by the R&D committee at this institution. Results: No formal guidelines on documentation of penicillin allergy were identified, although use of an alert card or red/white stickers in patients’ drug charts did exist. No set criteria were identified to enable (HCPs) to interpret patients’ accounts of self reported allergy as being either IgE-or non-IgE-mediated. A lack of documentation existed in 9% of patients’ notes (n=100) with (p≤ 0.03). Also, there was a lack of implementation of policies regarding insertion of an alert card in the medical notes and placing a red/white sticker on the drug chart (p≤0.0001). There appeared to be an over-reporting of penicillin allergy by 10% in the validated cases (n=59, p≤0.035) with 87% of the patients (p≤0.035) stating an allergy to penicillin. Although 63.3% of HCPs were aware of the true penicillin allergy reaction signs and symptoms, 23.3% considered the side effects as an allergic reaction and 13.3% were unaware of the characteristics of an allergic reaction (p≤ 0.048). From the HCPs questionnaires (n=30), 57% had not received any formal training in this area, 43% were pharmacists and only 62% had an input on drug allergy documentation (p≤0.009).
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1 Cost effectiveness of community p
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2 The Diabetes Pilot Program: Barri
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3 The PINCER trial: a cluster rando
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4 How pharmacists working on the PI
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5 A systematic review of weight man
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6 An exploration of the potential i
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8 Unintended discrepancies between
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9 Unlicensed Medicines: Risk and Re
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Page 35 and 36: 18 The Role of the Pharmacist and E
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Page 61 and 62: 31 Inappropriate prescribing of Opi
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61 Ensuring accuracy in routinely c
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62 Deprivation status and utilizati
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63 Exploring Reasons, Factors and A
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64 I’m off to the gym: Exploring
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65 Is there alignment between the v
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66 The views of out-patients with c
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67 Patient Experiences of Living wi
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68 Clinical management and cost of
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69 Medicines Use Reviews - how have
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70 How are pharmacists, registered
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71 Barriers facing hypertensive pat
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72 Developing an RCT of general pra
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73 User and Staff Perspectives of C
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75 How do patients with osteoporosi
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76 Integrating tuberculosis and dia
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77 Improving outcomes and quality o
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81 The prevalence of pharmacists’
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85 Fitness to practise: pharmacists
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87 Benzyl Alcohol Exposure from Hep
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88 Neonatal gentamicin infusions- W
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89 Unlicensed and off-label use of
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90 Unlicensed and off-label prescri
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91 Exploring community pharmacists
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92 Investigation into Rapid Microbi
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93 Pharmacy prescribing in XXXX-a q
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94 Pharmacy prescribing in XXXX-a q
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95 MEDICINE RELATED PROBLEMS IN SOU
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96 Stability of pharmaceutical prod
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97 The experiences of Malaysian pha
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98 Medication management in older p
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99 Adherence with calcium and vitam
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100 Appraisal systems within commun
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101 The clinical impact of a fractu
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102 An audit of primary care prescr
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103 Views of the public on over-the
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RPS Conference 2010, Abstracts 2010 - Royal Pharmaceutical Society

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