Ms Fiona Wilson, Dr Alison Ratcliff, Ms Jane Frankling
1Public Health Services , Hobart, Australia
2Public Health Services , Hobart, Australia
3Tasmanian Health Service, Launceston, Australia
Introduction: The Tasmanian Infection Prevention and Control Unit have overseen antimicrobial use surveillance in Tasmanian District (Rural and Remote) Hospitals since 2016.
Methods: Nurses in District Hospitals collect data on all inpatient antimicrobial use over one calendar month annually. An Infectious Diseases Physician assesses appropriateness, in accordance with National Antimicrobial Prescribing Survey (NAPS) definitions. Data is entered into the NAPS portal and a report, including state-wide benchmarking, provided to individual hospitals.
Results: Over the six years of the program, the most common indications for antimicrobial use were respiratory tract infections, skin and soft tissue infections and urinary tract infections.
Total prescriptions decreased from 225 (2016) to 161 (2021).
Appropriateness of prescribing increased from 62% (2016) to 82% (2021).
Antimicrobials most prescribed in 2021 were amoxicillin-clavulanate, ceftriaxone, doxycycline, amoxicillin, and cefalexin.
Conclusions: The program is embedded in District Hospitals with most sites participating. Improvements correlate with the introduction of a remote clinical pharmacy service, building from an implementation pharmacist in 2016, with 2.8 additional clinical pharmacists in 2020. This team considers appropriateness of antimicrobials when reviewing patients and prior to supply.
Infectious Diseases Physician staffing at Tertiary Hospitals also expanded in 2018-2020, allowing more time to be dedicated to associated District Hospitals and increasing access to specialist advice for Rural Medical Practitioners.
Survey results are provided to Antimicrobial Stewardship Committees, individual hospitals, and prescribers, and recommendations from previous reports have been actioned.
Practitioner feedback has also been sought and acted upon, including improving access to the Therapeutic Guidelines.
Biography: Fiona Wilson has a background in infectious diseases nursing and has been working in Infection Prevention and Control since 1997 in Victoria and Tasmania. Fiona is currently the Nurse Manager for the Tasmanian Infection Prevention and Control Unit within Public Health Services in the Department of Health, Tasmania.