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dc.contributor.authorHamill, Laura M
dc.contributor.authorBonnett, Julia
dc.contributor.authorBaxter, Megan F
dc.contributor.authorKreutz, Melina
dc.contributor.authorDenny, Kerina J
dc.contributor.authorKeijzers, Gerben
dc.date.accessioned2021-08-06T04:17:13Z
dc.date.available2021-08-06T04:17:13Z
dc.date.issued2021
dc.identifier.issn2079-6382
dc.identifier.doi10.3390/antibiotics10070843
dc.identifier.urihttp://hdl.handle.net/10072/406655
dc.description.abstract<jats:p>Objective: Inappropriate antimicrobial prescribing in the emergency department (ED) can lead to poor outcomes. It is unknown how often the prescribing clinician is guided by others, and whether prescriber factors affect appropriateness of prescribing. This study aims to describe decision making, confidence in, and appropriateness of antimicrobial prescribing in the ED. Methods: Descriptive study in two Australian EDs using both questionnaire and medical record review. Participants were clinicians who prescribed antimicrobials to patients in the ED. Outcomes of interest were level of decision-making (self or directed), confidence in indication for prescribing and appropriateness (5-point Likert scale, 5 most confident). Appropriateness assessment of the prescribing event was by blinded review using the National Antibiotic Prescribing Survey appropriateness assessment tool. All analyses were descriptive. Results: Data on 88 prescribers were included, with 61% making prescribing decisions themselves. The 39% directed by other clinicians were primarily guided by more senior ED and surgical subspecialty clinicians. Confidence that antibiotics were indicated (Likert score: 4.20, 4.35 and 4.35) and appropriate (Likert score: 4.07, 4.23 and 4.29) was similar for juniors, mid-level and senior prescribers, respectively. Eighty-five percent of prescriptions were assessed as appropriate, with no differences in appropriateness by seniority, decision-making or confidence. Conclusions: Over one-third of prescribing was guided by senior ED clinicians or based on specialty advice, primarily surgical specialties. Prescriber confidence was high regardless of seniority or decision-maker. Overall appropriateness of prescribing was good, but with room for improvement. Future qualitative research may provide further insight into the intricacies of prescribing decision-making.</jats:p>
dc.description.peerreviewedYes
dc.languageEnglish
dc.publisherMDPI
dc.relation.ispartofpagefrom1
dc.relation.ispartofpageto14
dc.relation.ispartofissue7
dc.relation.ispartofjournalANTIBIOTICS-BASEL
dc.relation.ispartofvolume10
dc.subject.fieldofresearchEmergency medicine
dc.subject.fieldofresearchcode320207
dc.subject.keywordsScience & Technology
dc.subject.keywordsLife Sciences & Biomedicine
dc.subject.keywordsInfectious Diseases
dc.subject.keywordsPharmacology & Pharmacy
dc.subject.keywordsantibiotics
dc.titleAntimicrobial Prescribing in the Emergency Department; Who Is Calling the Shots?
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationHamill, LM; Bonnett, J; Baxter, MF; Kreutz, M; Denny, KJ; Keijzers, G, Antimicrobial Prescribing in the Emergency Department; Who Is Calling the Shots?, ANTIBIOTICS-BASEL, 2021, 10 (7), pp. 1-14. DOI: https://doi.org/10.3390/antibiotics10070843
dcterms.licensehttps:// creativecommons.org/licenses/by/4.0/
dc.date.updated2021-08-05T00:47:27Z
dc.description.versionVersion of Record (VoR)
gro.rights.copyright© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/4.0/).
gro.hasfulltextFull Text
gro.griffith.authorKeijzers, Gerben


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