Ms Robyn Birch1, Ms Sophie Paviour1, Troy Howells1
1QLD Health, Central West HHS – Longreach, Australia
Biography:
Robyn Birch has been a nurse for over forty years with twenty of those in infection control. In recent years she headed far out west on an adventure that eventually saw her accept a permanent position with Central West Hospital and Health service.
Abstract:
The National Safety and Quality Health Service (NSQHS) standards require organisations to demonstrate robust Antimicrobial Stewardship (AMS), ensuring prescribing aligns with current therapeutic guidelines. Central West Hospital and Health Services (CWHHS), the largest geographical health service in Queensland, includes five small rural hospitals and ten Primary Health Centres (PHCs). With only two pharmacists covering clinical and medication management across this vast area, meeting AMS requirements posed a significant challenge. A new approach to antimicrobial surveillance in remote areas was needed.
A search revealed no appropriate audit tools for these settings. In collaboration with AMS experts and local clinicians, the CWHHS pharmacist worked with remote nursing workforce to develop a novel audit tool based on the Quality Improvement (QI) National Antimicrobial Prescribing Survey (NAPS). A pilot at two sites evaluated the tool for usability, accuracy, relevance, and validation. After incorporating feedback, the tool was integrated into the electronic audit platform ‘MARS’ and implemented across CWHHS. Implementation was supported through pharmacy-led education and Infection Control ICPs via virtual meetings and site visits. Data analysis was conducted by Queensland Statewide Antimicrobial Stewardship Program (QSAMSP).
CWHHS has progressed from non-compliance to compliance in antimicrobial surveillance at all sites. Seven PHCs now contribute data, with early results showing high compliance with the Primary Clinical Care Manual.
A team approach for AMS is critical for success especially in rural and remote locations. Empowering nurses enabled reflection on practice and insight into prescribing influences. Engaging staff from tool development to audit feedback supported ownership of the program.