Aids to structuring antimicrobial stewardship rounds and improving documentation

We’ve used the following aids at John Hunter Hospital for some years which others are very welcome to adopt/adapt:

a) For post-empiric AMS rounds,  patients on restricted antibiotics which have been registered on our computerised system with a non-standard indication, we structure the notation of the patient notes by using a stamp (below). Against Antimicrobial, we notate the day of therapy – eg. ceftriaxone d1 . If the indication has not been made clear, we enter ‘undocumented’ against that item. We will also detail whatever documented evidence there is concerning the indication – eg. CXR changes, CRP, WCC etc.  All evaluations are followed up with a phone call to the team which is documented.  The date, time and AMS round personnel are also notated.   The sequence basically follows the first part of the AIMED approach to prescription that we promote district-wide.

AMS stamp

b) On the Intensive Care AMS rounds, we use a small sticker that owes its genesis to a publication noticed by our Director of ICU. The idea was adapted and has served good purpose.  The stickers are printed 8 to an A4 printed label page- ICU Antibiotic Plan Labels 8 .

ICU sticker

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