Evaluation of prescribers' knowledge, training and access to guidelines for paediatric antibiotic prescribing at a district general hospital.

Abstract

We conducted a survey of all staff who had a prescribing role (including postgraduate doctors in training, specialty doctors, nurse practitioners and specialist nurses) to determine current practices in prescribing antimicrobials and confidence when prescribing for paediatric patients. We had 47 responses, with most respondents working in paediatrics (34%, n=16), Medicine (n=13) and surgical specialties (n=10). The majority had over 3 years of clinical experience post qualification, however, most (74%, n=35) had less than 6 months or no experience in paediatrics within their training. Approximately 94%, (n=44) prescribed antimicrobials as part of their job, either daily (40%, n=19) or 2�4 times a week (51%, n=24), usually without senior supervision. Nearly all (92%, n=43) used existing online prescribing tools available at the trust. Approximately 80% (n=37) stated antimicrobial resistance was considered when prescribing, however only 11% (n=5) said they found knowing when to switch from IV to oral antibiotics easy, with the majority (77%, n=36) stating their decision was dependent on the case. Only 31% (n=15) stated that a non-optimal or unsafe antimicrobial prescription would be reported directly back to the prescriber if noticed. When asked about confidence prescribing antimicrobials on a 1�5 Likert scale (1 = not confident, 5 = very confident), respondents were more confident prescribing antimicrobials in adult compared with paediatric patients (2.9 vs 1.8) which only improved slightly (2.2) for those working in paediatrics. Most (80% n=37) stated they would like more training prescribing antimicrobials in paediatrics, either online or during induction, while senior support and reading local guidelines were considered to be the most valuable for learning on the job. Appropriate antimicrobial prescribing is essential for patient care and antimicrobial stewardship, however staff lack confidence in prescribing antimicrobials for paediatric patients compared with adults. Implementation of a paediatric. An antibiotic prescribing app may be an effective tool to educate staff, reduce prescribing errors and improve antimicrobial stewardship.1�We plan to develop an app as a collaboration between the local paediatric, microbiology and pharmacy teams and repeat this survey to determine if introduction and use of the app improves prescribing practices.