Skills learned during critical care prospective audit and feedback are utilized outside of the stewardship environment
CCCF ePoster library. Fleming D. Oct 26, 2015; 117342; P40 Disclosure(s): Nothing to disclose
Dimitra Fleming
Dimitra Fleming
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Abstract
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Skills learned during critical care prospective audit and feedback are utilized outside of the stewardship environment
Fleming D1, Ali K1,2, D’Sa R1,2, Powis J1,3,4,5

1 Niagara Health System, Niagara Region, Ontario, Canada
2 Michael G. Degroote School of Medicine, McMaster University, Niagara Region, Ontario, Canada
3 Toronto East General Hospital, Toronto, Ontario, Canada
4 University of Toronto, Toronto, Ontario, Canada
5 IGNITE Consulting, Toronto, Ontario, Canada

Background: Antimicrobial stewardship is crucial to optimize antimicrobial utilization in critical care. Prospective audit and feedback (PAF) is the major intervention used by stewardship programs, yet the impact on clinicians’ antimicrobial prescribing behaviours outside of the formal stewardship environment is unknown. We sought to understand if skills learned during PAF are translated to other areas of clinicians’ practice.
Methods: Antimicrobial stewardship, through biweekly PAF, was initiated in a 14 bed closed medical-surgical ICU at a single site of a multi-site, community hospital. Antimicrobial stewardship was not initiated in ICU B and C, located at different sites of the same hospital. However, some physicians working in ICU B also worked in ICU A and therefore were exposed to PAF while at ICU A. Physicians at ICU C had no exposure to PAF. Antimicrobial utilization was compared for all 3 ICUs before and after PAF implementation.
Results: During the intervention period 61.7% days of service in ICU B were covered by physicians who also worked in ICU A. Broad-spectrum and anti-pseudomonal antimicrobial use was decreased post PAF implementation in ICU A by 27.1% (p =0.00066) and 44.9% (p = 0.00066) respectively and in ICU B by 21.7% (p = 0.01477) and 28.7% (p = 0.00326) respectively. There was no change in antimicrobial utilization in ICU C.
Conclusion: Prospective audit and feedback has the potential to change antimicrobial prescribing behaviours among ICU clinicians. Knowledge and skills learned during prospective audit and feedback are translated to practice settings outside of the formal stewardship environment
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