title: Electronic prescribing: Reducing delay to first dose of antibiotics for patients in intensive care.
abstract: Delays in antibiotic therapy in the context of severe sepsis are associated with increased mortality. One way to reduce such delays may be through modifications to electronic prescribing (EP) systems. The research team evaluated the role of one such EP system in reducing delays in antibiotic administration in an Intensive Care Unit (ICU). First, the delays in antibiotic administration in adult ICU patients was quantified. The EP system was then modified to remove deafult time settings for antibiotic doses, which ensured that all antibiotic doses were scheduled for administration within an hour of the prescription being generated. Enhanced training for clinicians and nurses was also implemented, focusing on the EP system and highlighting the importance of prompt antimicrobial prescribing and delivery to the patient. The antibiotic administration was re-audited, and a significant reduction in delays (p=0.002, Mann-Whitney U test) was found. This study demonstrates how prudent use of EP systems can help to reduce delays in antibiotic administration in an ICU setting, thus potentially contributing to reducing mortality in patients with sepsis.
authors.affiliation: Oxford University Hospitals NHS Trust.
authors.forename: Philippa C
authors.initials: PC
authors.lastname: Matthews
authors.affiliation: Oxford University Hospitals NHS Trust.
authors.forename: Tri
authors.initials: T
authors.lastname: Wangrangsimakul
authors.affiliation: Oxford University Hospitals NHS Trust.
authors.forename: Mark
authors.initials: M
authors.lastname: Borthwick
authors.affiliation: Oxford University Hospitals NHS Trust.
authors.forename: Clare
authors.initials: C
authors.lastname: Williams
authors.affiliation: Oxford University Hospitals NHS Trust.
authors.forename: Ivor
authors.initials: I
authors.lastname: Byren
authors.affiliation: Oxford University Hospitals NHS Trust.
authors.forename: Douglas
authors.initials: D
authors.lastname: Wilkinson