R. Cheah1,2, C. Chen1,2, J. Maleki1,2, N. Truong1,2, Z. Rashidzada1,2, K. Buising1,2, K. Thursky1,2, P. Varghese2, R. James1,2 and N. Bennett1,2
1 National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia, 2 The RMH Guidance Group, 2The Royal Melbourne Hospital, Melbourne, Victoria, Australia
Abstract:
Introduction
Identifying, measuring and monitoring inappropriate antimicrobial prescribing practices is a priority for improving patient care and addressing AMR. Documentation of the reason for prescribing an antimicrobial, or the “indication”, is essential to enable these activities. Digital clinical systems often capture indications inconsistently e.g. as an optional field, or as free text entry leading to highly variable nomenclature.
Methods
The Universal Indications List (UIL) was developed with the aim to address this; it is a live cloud-hosted standardised antimicrobial indication list that is curated and refined iteratively and managed and maintained by a committee of clinical experts. Indications are ‘tagword’ enabled for improved searching, can be classified into different hierarchies to allow reporting at different levels, may be customized by users to cater for different contexts, and were SNOMED-CT coded to enhance interoperability.
Results
The UIL has been embedded in the Hospital National Antimicrobial Prescribing Survey, an auditing platform that measures antimicrobial appropriateness of use and quality of prescribing indicators implemented as a national program in Australia and abroad, and in antimicrobial stewardship decision support and post prescription review programs.
Conclusion
The UIL standardises antimicrobial indication nomenclature and enables interoperability across diverse healthcare settings. It improves data quality, reduces non-auditable indications, and enables more standardised reporting.