Original Research Article
Year: 2019 | Month: February | Volume: 9 | Issue: 2 | Pages: 180-190
Rapid Cycle Analysis and Daily-Defined Dose as Tools to Audit Antibiotic Policy on the Usage of Restricted Antibiotics: Suggesting Corrective Changes
Divya Dikshit1, Prof M. Mariappan2, Dr Rahul S Kamble3
1Student 2nd year Masters of Hospital Administration – Tata institute of social sciences, Mumbai
2Centre for Hospital Management, School of Health Systems Studies, Tata institute of social sciences, Mumbai
3Consultant Microbiologist & Infection control Nodal officer-Lilavati Hospital, Mumbai,
Corresponding Author: Divya Dikshit
ABSTRACT
Antibiotics are medicines, which are used under restricted conditions. Sometimes it has become essential for controlling serious infections. Administration of Antibiotics is governed by certain policies of the hospital. Further these policies usually undergo a periodic review at the regular interval. Antibiotics have both positive and negative impact, it depends how best it is used for the right purposes. Basically it contributes significantly to decrease morbidity and mortality by the way of minimizing the risk of health-associated infections. On the other hand, unregulated use of antibiotics could lead to serious problems to the patients. Hence, appropriate guidelines, policies and protocol is essential to ensure right use of antibiotics. The study focuses on the factors that contribute to make better policies, which will have greater impact on the use of antibiotics. To achieve an effective result of antibiotic policy audit, approach was adopted to study “restricted antibiotics”, which are the newer antibiotics scheduled under schedule H1 which will be accessible only in tertiary care hospitals. A retrospective study was done with samples collection, which was guided by ICD codes. A total of 120 samples were assessed which was 20% of total data of 699 cases with probability of using restricted antibiotic. A three way approach adoption was suggested with Rapid cycle analysis of clinical case data from Medical Records Department, DDD (daily defined dose) utilization data from pharmacy department, and third, which was not implemented due to permission issues, sending out Google forms to clinical staff to get understanding of clarity of policy to staff. Analysis was done by excel and SPSS. The results show that there has been some gap between the policies and practice. It is important to match that the best practices to be adopted in the policies document at the regular interval and similarly the approved policies to be implement strictly by the professionals.
Key words: Antibiotic policy, Rapid cycle analysis, DDD (daily defined dose), Antibiotic policy audit, restricted antibiotics