Improving Pre-emptive Prescribing to Relieve Patient Discomfort Occurring Out of Hours

"Junior doctors are commonly asked to prescribe simple medications for symptom relief for patients out of hours. Unfortunately, time constraints and other pressures may lead to delays before the medications are prescribed. A quality improvement project was conducted at a large university teaching hospital to establish the extent of the problem, with the aim of finding measures to improve preemptive prescribing for patients."

Improving Pre-emptive Prescribing to Relieve Patient Discomfort Occurring Out of Hours
R Williams, F Herbert, A Orme, G Casswell

BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u206301.w3757

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Improving antibiotic prescribing practice in a respiratory ward

"This project aims to improve compliance with documentation of indication and duration of antibiotic use in line with our local antibiotic prescribing guidelines. Post-intervention results were encouraging with compliance rates increasing from 24% to 94% for indication, and from 39% to 71% for duration."

Antimicrobial stewardship: Improving antibiotic prescribing practice in a respiratory ward
JM Yeo
BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u206491.w3570

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Improving paediatric prescribing practice in a district general hospital

"A driver diagram identified three components contributing to prescribing errors and relevant tests of change were developed. The three primary drivers included education and communication, practical prescribing changes, and medicine reconciliation."

Improving paediatric prescribing practice in a district general hospital through implementation of a quality improvement programme
P Donnelly, S Lawson, C Watterson
BMJ Quality Improvement Report2015;4: doi:10.1136/bmjquality.u206996.w3769

 

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Improving the safety of oxygen therapy

"Our quality improvement project aimed to increase the safety of oxygen therapy at University Hospitals Bristol NHS Foundation Trust. We aimed to increase the rate of oxygen prescribing and increase the percentage of nurses signing appropriately for oxygen titration and administration."

Changing an ingrained culture: Improving the safety of oxygen therapy at University Hospitals Bristol NHS Foundation Trust
M Gatter, G Dixon, J Wall, E Mew
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u203238.w1474

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Safer fluid prescribing

"The National Institute of Clinical Excellence (NICE) released new fluid guidelines following data suggesting 20% of patients receiving fluids suffer adversely (2013). This quality improvement group assessed fluid prescribing in a tertiary teaching centre and introduced a new fluid- prescribing chart to align practice with NICE recommendations."

Safer fluid prescribing at North Bristol Trust: Bringing practice in line with NICE Guidance with a redesign of the fluid prescription chart
J Andersson et al.
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u203816.w1911

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Out of hours intravenous fluid therapy

"Recent NICE guidance has highlighted the importance of appropriate and safe intravenous fluid use. We aimed to improve the quality of out of hours fluid prescription in a Bristol hospital by ensuring that indications and cautions for fluid therapy were clearly documented at the time of initiation."

Out of hours intravenous fluid therapy: a prompt to guide prescribing
J Fehmi et al.
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u204010.w3139

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Intravenous fluid prescribing: Improving prescribing practices

"as a result of improved documentation and consideration given to fluid prescriptions, we were able to increase the percentage of maintenance IV fluid prescriptions that conformed to NICE guidelines."

Intravenous fluid prescribing: Improving prescribing practices and documentation in line with NICE CG174 guidance
BMJ Quality Improvement Reports 2014;3: doi:10.1136/bmjquality.u205899.w2409

LT Sansom, L Duggleby

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