Enhancing the quality of antimicrobial prescribing through education in NHSScotland

BackgroundThe Scottish Antimicrobial Prescribing Group (SAPG) was established by Scottish Government to support the delivery of the Scottish Management of Antimicrobial Resistance Action Plan (ScotMARAP). The primary objective of SAPG is to co-ordinate a national framework of antimicrobial stewardship to enhance the quality of antimicrobial prescribing and infection treatment in Scotland.

NHS Education for Scotland (NES) supports SAPG by leading the education work stream to ensure that education on antimicrobial prescribing is available for all healthcare professionals throughout Scotland. A range of education resources have been developed.

NHS Education for Scotland2

Education and Training Resources

Pharmaceutical Care of Patients with InfectionsPharmacists and pharmacy technicians across Scotland are regularly offered the opportunity to attend face-to-face courses on the Pharmaceutical care of patients with infections. Course materials are available on the NES website for self directed study and include:

¡ webcast presentations on ‘Bugs and Drugs; case studies and answers on upper respiratory infections (including pneumonia), skin and soft tissue infections and urinary tract infections

¡ additional information on prudent prescribing of antimicrobials

For more information visit the NES website http://ow.ly/w7ndS

Antimicrobials and infection management This e-learning course is aimed at pharmacy practitioners, but may be of interest to other prescribers. It was originally created by NES Pharmacy’s sister centre in Northern Ireland. Topics include:

¡ action and uses of commonly used antimicrobial agents

¡ selecting agents according to patient need

¡ antimicrobial prophylaxis

¡ monitoring patients on antimicrobials

¡ managing, preventing and controlling commonly-encountered healthcare associated infections (HAIs).

A Multiple Choice Assessment (MCQ) is available to complete on Portal (www.portal.scot.nhs.uk) for pharmacists and pharmacy technicians.

For more information visit the NES website http://ow.ly/w53L7

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The Scottish Reduction in Antimicrobial Prescribing (ScRAP) ProgrammeThe ScRAP Programme, launched in October 2013, is an educational toolkit to help prescribers reduce unnecessary prescribing of antibiotics and to support NHS Boards in delivering the level 3 HEAT target on antibiotic volume. It was developed by NES (Pharmacy) in conjunction with the Scottish Antimicrobial Prescribing Group (SAPG).

The ScRAP Programme is usually delivered by prescribing support staff within local boards. It explores antimicrobial prescribing using a number of elements including

¡ recommended pre-event online learning

¡ reflection on the Prescribing Information System for Scotland (PRISMS) data for the practice/individual prescriber

¡ a facilitated structured learning event supported by a pre-recorded DVD presentation.

The DVD supports the facilitator, who delivers the Programme, by providing all the key clinical evidence around the need to reduce unnecessary prescribing of antimicrobials.

Copies have been distributed to all Health Boards via local prescribing support teams and Antimicrobial Management Teams. Additional copies can be requested by those facilitating the Programme locally by contacting NES Pharmacy at pharmacy@nes.scot.nhs.uk

For more information visit the NES website http://ow.ly/pDXzh

NHS Education for Scotland4

This comprehensive training pack is designed for local trainers to support practitioners who are involved in the prescribing, monitoring and administration of antibiotics in their early stages of clinical practice. It will also be of value to those returning to practice or those wishing to refresh their knowledge of contemporary approaches to antimicrobial therapy in Scotland.

The resource comprises a schedule of learning outcomes, an editable MS PowerPoint training presentation and a CPD record of evidence of learning. All components are available to download from the NES website.

For further information visit the NES website http://ow.ly/x05B2

Training on the use ofAntimicrobials in Clinical Practice

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Online Short Courses

There are a range of online modules available via learnPro and these include the following:

NHS Education for Scotland6

for Today’s Practitioner

The online module aims to heighten awareness of contemporary approaches to antimicrobial management and issues relating to clinical effectiveness, patient safety and the reduction of bacterial resistance.

There is a selection of e-learning vignettes for the learner to work through, based on a wide range of different infections, presenting in a variety of settings. Each has an estimated completion time of 20-40 minutes.

The target group includes medical prescribers in hospital and community settings; non-medical prescribers including nurse practitioners, specialist nurses, community pharmacists; clinical practitioners involved in administering and monitoring of antibiotic treatment or management of infection; and members of Antimicrobial Management Teams and infection control practitioners.

For further information visit the NES website http://ow.ly/x03FS

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Gentamicin and Vancomycin

These self directed online modules provide the most up-to-date national guidance to support the safe and effective use of gentamicin and vancomycin in adults and are based on the 2013 Scottish Antimicrobial Prescribing Group guidance. The target groups for the modules are hospital prescribers including foundation year doctors and non-medical prescribers and clinical practitioners involved in administering and monitoring antibiotic treatment.

On completion of the modules learners will have an understanding of the requirements for safe prescribing including calculating the initial dose, monitoring therapy (including assessing for toxicity) and adjusting dosage regimens and the methods of administration.

There are two gentamicin modules; one following the Hartford guidance and the other following Greater Glasgow and Clyde guidance. There are two vancomycin modules; one for intermittent infusion and one for continuous infusion. Modules are available via learnPro and have been allocated to health boards based on the guidance adopted locally in practice.

For further information visit the website http://ow.ly/x04ev

NHS Education for Scotland8

This self-directed online tutorial describes the biology and epidemiology of Clostridium difficile infection (CDI). It is aimed at a wide range of staff including specialist nurses, antimicrobial management teams and consultant level physicians and surgeons. It will improve the learner’s knowledge on the prevention, diagnosis and treatment of CDI, the spectrum of disease and its presentation.

For further information visit the website http://ow.ly/x04Ii

This self-directed online module describes the appropriate clinical management of Clostridium difficile infection (CDI) including infection control measures to the spread of infection. The module portrays a clinical situation and the learner is asked questions based on the management of an individual case. The module is aimed at a wide range of staff including doctors at consultant, SpR and foundation level, infection control teams, specialist nurses and clinical staff with an interest in the management of patients with CDI.

For further information visit the website http://ow.ly/x04Op

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The Bacterial Resistance Tutorial is for clinical practitioners wishing to update their knowledge of the principles of bacterial resistance or staff new to this topic wanting to learn the principles of bacterial resistance and its clinical relevance.

For further information visit the website http://ow.ly/x04Xp

Promoting Hand Hygienein Healthcare

This self-directed online resource is designed to be used by any healthcare worker, student or carer within a hospital or community setting wishing to update, refresh or challenge personal hygiene knowledge and practice.

For further information visit the website http://ow.ly/x057j

NHS Education for Scotland10

Priorities for 2014-16

NES will continue to support the implementation, maintenance and evaluation of these education resources and respond to emergent educational needs of NHSScotland as identified by the SAPG and Scottish Government HAI Task Force.

Links

NHS Education for Scotland, Healthcare Associated Infection Educationhttp://www.nes.scot.nhs.uk/education-and-training/by-theme-initiative/healthcare-associated-infections.aspx

NHS Education for Scotland, Pharmacy Directoratehttp://www.nes.scot.nhs.uk/education-and-training/by-discipline/pharmacy.aspx

Scottish Antimicrobial Prescribing Group (SAPG)http://www.scottishmedicines.org.uk/SAPG/Scottish_Antimicrobial_Prescribing_Group__SAPG_

Scottish Government Healthcare Associated Infection Task Forcehttp://www.scotland.gov.uk/Topics/Health/Services/Preventing-Healthcare-Infections/Infection-Monitoring/Taskforce

UK Five Year Antimicrobial Resistance Strategy 2013-2018https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/244058/20130902_UK_5_year_AMR_strategy.pdf

The Scottish Management of Antimicrobial Resistance Action Plan (ScotMARAP)http://www.scotland.gov.uk/Resource/Doc/215645/0057700.pdf

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NHS Education for ScotlandWestport 102, West PortEdinburgh EH3 9DNTel: 0131 656 3200Fax: 0131 656 3201

www.nes.scot.nhs.uk

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© NHS Education for Scotland 2014. You can copy or reproduce the information in this document for use within NHSScotland and for non-commercial educational purposes. Use of this document for commercial purposes is permitted only with the written permission of NES.