CLINICAL POLICIES: INFECTION CONTROL
Title
Portsmouth Hospitals NHS Trust Antimicrobial Strategy
Version
4
Reference number
1.2
Manager /
committee
responsible
Infection Control Management Committee
Date Agreed
22 April 2014
Date issued
12 February 2015
Review date
01 April 2015
Equality impact
assessment has
been applied to
this policy
Adel Sheikh Antibiotic Pharmacist
Author
Dr Robert Porter, Consultant Microbiologist Mr Adel Sheikh, Antibiotic
Pharmacist
Ratified by
Infection Control Management Committee
PHT Antimicrobial Strategy
Version: 5
Issue Date: 12 February 2015
Review date: April 2015
Page 1 of 4
CLINICAL POLICIES: INFECTION CONTROL
Strategic Aim
The strategic aim of Portsmouth Hospitals NHS Trust (PHT) is to encourage and support
appropriate narrow spectrum, clinically effective antimicrobial prescribing, in a cost and timeefficient manner.
Achieving this aim
The following strategy has been drawn up to guide service development to help achieve this aim.
2014/15
 Complete empiric adult antimicrobial guidelines in app and online format
Paediatric app embedded, adult expanded guidelines to be completed in app format with
online version provided by Microguide. Link from intranet site.
 Electronic Prescribing and Medicines Administration procurement
Procurement of EPMA solution for Group A Collaborative (Bournemouth, Poole, Salisbury
and Portsmouth), with implementation phase commencing in 2015.
 Electronic learning package
Completion of E-learning package, and roll out to Trust.
 Antimicrobial pharmacist time
1xWTE antimicrobial pharmacist post to be developed with funding for specialist training.
2013/14
 Successful integration of e-Prescribing to Trust
Integration of e-Prescribing into the current Trust infrastructure allowing patient specific
prescribing data and preferably with a clinical decision tool as part of the solution
 Continued development of infection portal (website/app)
To build on the initial base to provide a site with clinically relevant information and
management advice, including infection control updates and breaking news
 Development of a patient-centred approach to antimicrobial stewardship using
patient data from e-Prescribing system
Using e-Prescribing data to broaden approach of antimicrobial stewardship to include all
patient relevant data e.g. use of PPIs, interacting drugs, extended antimicrobial course, and
informing decisions for specific clinical review
 Develop an effective strategy for reducing unnecessary use of broad spectrum
antimicrobials
Using e-Prescribing to allow focussed antimicrobial intervention in patients prescribed high
risk, broad-spectrum or high cost drugs. To have the ability to restrict antimicrobial
prescribing where appropriate.
 Integration of regular point-prevalence data from all wards with local buy-in and
feedback
With e-prescribing feedback to individual prescribers becomes possible, plus ward level
data for team feedback.
 Increased antimicrobial pharmacist time allocation
PHT Antimicrobial Strategy
Version: 5
Issue Date: 12 February 2015
Review date: April 2015
Page 2 of 4
CLINICAL POLICIES: INFECTION CONTROL
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Trust commitment to training and supporting 1 WTE antimicrobial pharmacist to focus on
stewardship, new drug horizon scanning, and prescriber education and feedback.
Increased board level involvement in antimicrobial stewardship with regular board
updates
Roll out of an antimicrobial e-learning package developed locally in conjunction with
neighbouring Trusts.
This package will aim to inform and educate healthcare professionals in best practice
prescribing, and can be used at induction and as a regular update or refresher to
permanent members of staff
Monitoring, improving and optimising antimicrobial prescribing
Antimicrobial prescribing will be monitored for improvement using audits carried out as described in
the antimicrobial prescribing policy. The results of the antimicrobial prescribing audits will be fed
back to the Infection Control Management Committee and all relevant clinical areas.
The AMG will meet at least quarterly. This group will guide and manage safe, effective and
economic use of antimicrobials within the Trust. In doing so it will contribute to Trust targets for the
reduction in healthcare-associated infections, by the monitoring of antimicrobial use and
resistance, management of policies and guidelines relating to antibiotics, reviewing antimicrobial
prescribing audits and new antimicrobial prescribing initiatives and encouraging and providing
education. The AMG meetings will be chaired by the Trust antimicrobial lead and the minutes will
be filed on the shared pharmacy drive. The actions from these meetings will be fed back to the
Trust via the Formulary & Medicines Group and the Infection Control Management Committee. In
2013 the chief medical officer warned of the real and present threat posed by antimicrobial
resistance. Senior board level involvement is essential in steering the Trust safely through future
rough seas.
Trust-wide microbiology ward rounds provide regular expert advice on antimicrobial prescribing to
the medical and nursing staff. An increasingly clinical service will be aided by updates in the
microbiology laboratory which will allow improved use of consultant time through use of clinical
scientists and an improved laboratory information management system.
Requirements for fulfilment of this strategy
 Sufficient numbers of qualified pharmacists to allow all prescription charts to be
reviewed on a regular basis.
 1 WTE band 8a pharmacist acting as the lead antibiotic pharmacist for the Trust and
0.5 WTE band 7 pharmacist to support the Trust lead antimicrobial pharmacist
 Adequately resourced microbiology laboratory with quality assurance procedures in
place.
 Sufficient numbers of microbiology and infection doctors to allow regular ward rounds.
Royal College of Pathologists guidance from 2001 states that for our current population
(520,000) and renal specialist services there should be 4.0 WTE consultant
microbiologists. This guidance predates the expansion of Infection Prevention targets.
There are currently 3.45 WTE consultant microbiologists
 Adequately resourced infection control team to support education and surveillance on
antimicrobial resistance and nosocomial infection.
PHT Antimicrobial Strategy
Version: 5
Issue Date: 12 February 2015
Review date: April 2015
Page 3 of 4
CLINICAL POLICIES: INFECTION CONTROL
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Access for all staff in all clinical areas to computer-based up-to-date guidelines and the
British National Formulary.
Senior clinical support in all clinical areas to allow regular (mostly daily) review of all
antimicrobial prescribing.
Good Trust wide communication and information sharing.
Electronic prescribing to facilitate safe prescribing and reduce drug errors, and allow
targeted antimicrobial interventions making most use of limited resources
Adequate IT support of e-prescribing projects at roll-out.
PHT Antimicrobial Strategy
Version: 5
Issue Date: 12 February 2015
Review date: April 2015
Page 4 of 4