15 Nov 2017
Survey finds prolonged antimicrobial use and sub-optimal documentation of antimicrobial prescription
A national survey has highlighted potential concerns about antimicrobial prescribing in Australian aged care homes.
The aged care National Antimicrobial Prescribing Survey (acNAPS) is an annual audit of the prevalence of infections and antimicrobial prescribing practices in Australian aged care homes. The primary aim of this survey is to help these homes identify infections and look for opportunities to improve the use of antimicrobials.
The acNAPS was first piloted in 2015. The public reports for the 2015 and 2016 acNAPS are both available.
The preliminary results of the survey, conducted between June and September 2017, have now been communicated to all 293 participating homes. In 2017, the medication charts of 12,344 permanent, respite or transitional care residents were reviewed.
Key findings include:
- Many residents (9%) were prescribed an antimicrobial.
- Almost one-quarter (21.8%) of antimicrobials had been administered for longer than six months.
- There was widespread use (29.5%) of topical antimicrobials.
- The reason for the antimicrobial prescription was not documented for 22.1% of antimicrobials prescribed, and the review- or stop-date was not documented for 49.3% of antimicrobials prescribed.
- The was a high rate (33.2%) of prescribing for residents who did not meet objective clinical criteria for infection in the week prior to starting antibiotics.
Prof. Karin Thursky, director of the National Centre for Antimicrobial Stewardship (NCAS), says: “Monitoring the quality of antimicrobial use in aged care homes is especially important as elderly residents are vulnerable to infections and, therefore, more likely to be receiving antimicrobial therapy.”
“This type of review enables participating homes to reflect on opportunities to improve the safety and quality of antimicrobial use. Improved documentation, and careful review of the ongoing need for prolonged therapies are possible target issues.”
“We strongly recommend that all Australian aged care homes and multi-purpose services participate in the acNAPS in 2018 as part of their quality improvement activities.”
About the aged care National Antimicrobial Prescribing Survey (acNAPS)
The acNAPS is conducted by the National Centre for Antimicrobial Stewardship in partnership with the Victorian Healthcare Associated Infection Surveillance System Coordinating Centre. Both are based at the Peter Doherty Institute for Infection and Immunity (a partnership between the University of Melbourne and the Royal Melbourne Hospital). The survey tool was developed by the Guidance Group (Royal Melbourne Hospital). The acNAPS is supported by the Australian Commission on Safety and Quality in Health Care as part of the Antimicrobial Use and Resistance in Australia program.