title: Identification of targets for quality improvement in antimicrobial prescribing: the web-based ESAC Point Prevalence Survey 2009.
abstract: OBJECTIVE
  Since electronic prescribing is limited to few hospitals, point prevalence surveys, such as the standardized European Surveillance of Antimicrobial Consumption point prevalence survey (ESAC PPS), are an alternative tool for monitoring prescribing and helping to identify performance indicators and prescribing trends. The main objective of this study was to identify and assess targets for quality improvement.
  
  
  METHODS
  Each hospital had to carry out the survey within 2 weeks. Each department had to be surveyed in 1 day. Data collected, for all inpatients, included age and gender. For patients on systemic antimicrobial treatment, the antimicrobial/s, infection/prophylaxis site, reason in medical notes and guideline compliance were also collected. A central database using a web-based tool (WebPPS) developed in-house was used for data entry.
  
  
  RESULTS
  Combination of two or more antimicrobials accounted for 30% of use. Surgical prophylaxis was prolonged (>1 day) in 53% of cases. 'Intensive care' had higher proportions of treated patients (53% versus 29%), combination therapy (49% versus 31%), hospital-acquired infections (49% versus 31%) and parenteral administration (91% versus 61%). 'Reason in notes' was documented in 76%, and 'guideline compliance' occurred in 62% of patients.
  
  
  CONCLUSIONS
  The ESAC PPS provided useful information on the quality of prescribing, which identified a number of targets for quality improvement. These could apply to specific departments or whole hospitals. Intensive care, which has different characteristics, should not be compared with general wards with respect to combination therapy, hospital-acquired infections or parenteral proportion. The study confirmed that the ESAC PPS methodology can be used on a large number of hospitals at regional, national, continental or global level.
authors.affiliation: Infection Control Unit, Mater Dei Hospital, Msida, Malta. peter.zarb@ua.ac.be
authors.forename: Peter
authors.initials: P
authors.lastname: Zarb
authors.forename: Brice
authors.initials: B
authors.lastname: Amadeo
authors.forename: Arno
authors.initials: A
authors.lastname: Muller
authors.forename: Nico
authors.initials: N
authors.lastname: Drapier
authors.forename: Vanessa
authors.initials: V
authors.lastname: Vankerckhoven
authors.forename: Peter
authors.initials: P
authors.lastname: Davey
authors.forename: Herman
authors.initials: H
authors.lastname: Goossens
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003625:Data Collection; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data* / Q000639:trends*; D055695:Electronic Prescribing; D005060:Europe; D019983:Guideline Adherence / Q000639:trends; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D020407:Internet; D010818:Practice Patterns, Physicians' / Q000639:trends*; D011787:Quality of Health Care / Q000706:statistics & numerical data
chemical_list: D000900:Anti-Bacterial Agents