Mrs. Bianca Mills1
1Hunter New England Local Health District, New Lambton Heights, Australia
Biography:
Bianca Mills is an Antimicrobial Stewardship Pharmacist with Hunter New England Local Health District and a Fellow of the Australian and New Zealand College of Advanced Pharmacy. She is passionate about rural healthcare, advocating for rural voices in policy, and leading quality improvement projects to optimise antimicrobial use.
Abstract:
Antimicrobial Stewardship (AMS) programs are essential for optimising antimicrobial use, reducing toxicity, and limiting the development of multi-resistant organisms. However, small rural geographically isolated hospitals often lack on-site AMS expertise. In response, a Virtual AMS program was established following consultation with local clinicians and stakeholders.
A multidisciplinary team—comprising off-site clinicians (Infectious Diseases Physician, AMS Pharmacist, Clinical Pharmacist) and local staff (Transitional Nurse Practitioner, Junior Medical Officers, Nurse Unit Manager)—conducted weekly virtual ward rounds via teleconference. All inpatients prescribed antimicrobials as of 8:00 AM that day were reviewed, including those in general wards, maternity, and the emergency department. Each session averaged 20 minutes, with an average of six clinicians attending and 1–9 patients reviewed per meeting.
Over 25 weeks, a total of 123 patients’ antimicrobial regimens were assessed. An amendment to antimicrobial management was recommended in approximately three-quarters of cases, with two-thirds accepted and implemented by the treating team. A full evaluation of pre- and post-intervention antimicrobial appropriateness, guideline compliance, and broad-spectrum antimicrobial consumption is currently underway to measure the extent of the success of the project.
The Virtual AMS model has proven to be a feasible and acceptable strategy for delivering quality antimicrobial review in rural settings lacking specialist AMS staff. Final results will guide potential expansion of the program across other rural hospitals within the network.