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Enhancing the quality of antimicrobial prescribing through education in
NHSScotland
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Scottish Medicines Consortium
Scottish Antimicrobial Prescribing Group (SAPG)
Background
The Scottish Antimicrobial Prescribing Group (SAPG) was established by Scottish
Government to support the delivery of the Scottish Management of Antimicrobial
Resistance Action Plan (ScotMARAP). The primary objective of SAPG is to co-ordinate
a national framework of antimicrobial stewardship to enhance the quality of antimicrobial
prescribing and infection treatment in Scotland.
NHS Education for Scotland (NES) supports SAPG by leading the education work
stream to ensure that education on antimicrobial prescribing is available for all
healthcare professionals throughout Scotland. A range of education resources detailed
below have been developed.
Education and Training resources
Pharmaceutical Care of Patients with Infections
Pharmacists and pharmacy technicians across Scotland are regularly offered the
opportunity to attend face-to-face courses on the Pharmaceutical care of patients with
infections. Course materials are available on the NES website for self directed study and
include:
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webcast presentations on ‘Bugs and Drugs; case studies and answers on upper
respiratory infections (including pneumonia), skin and soft tissue infections and
urinary tract infections
additional information on prudent prescribing of antimicrobials
For more information visit the NES website http://ow.ly/w7ndS
Antimicrobials and infection management
This e-learning course is aimed at pharmacy practitioners, but may be of interest to
other prescribers. It was originally created by NES Pharmacy’s sister centre in Northern
Ireland. Topics include:
 action and uses of commonly used antimicrobial agents
 selecting agents according to patient need
 antimicrobial prophylaxis
 monitoring patients on antimicrobials
 managing, preventing and controlling commonly-encountered healthcare
associated infections (HCAIs).
A Multiple Choice Assessment (MCQ) is available to complete on Portal
(www.portal.scot.nhs.uk) for pharmacists and pharmacy technicians.
For more information visit the NES website http://ow.ly/w53L7
The Scottish Reduction in Antimicrobial Prescribing (ScRAP) Programme
The ScRAP Programme, launched in October 2013, is an educational toolkit to help
prescribers reduce unnecessary prescribing of antibiotics and to support NHS Boards in
delivering the level 3 HEAT target on antibiotic volume. It was developed by NES
(Pharmacy) in conjunction with the Scottish Antimicrobial Prescribing Group (SAPG).
The ScRAP Programme is usually delivered by prescribing support staff within local
boards. It explores antimicrobial prescribing using a number of elements including
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recommended pre-event online learning
reflection on the Prescribing Information System for Scotland (PRISMS) data for
the practice/individual prescriber
a facilitated structured learning event supported by a pre-recorded DVD
presentation.
The DVD supports the facilitator, who delivers the Programme, by providing all the key
clinical evidence around the need to reduce unnecessary prescribing of antimicrobials.
Copies have been distributed to all Health Boards via local prescribing support teams
and Antimicrobial Management Teams. Additional copies can be requested by those
facilitating the Programme locally by contacting NES Pharmacy at
pharmacy@nes.scot.nhs.uk
For more information visit the NES website http://ow.ly/pDXzh
Antimicrobials in Clinical Practice [logo]
This comprehensive training pack is designed for local trainers to support practitioners
who are involved in the prescribing, monitoring and administration of antibiotics in their
early stages of clinical practice. It will also be of value to those returning to practice or
those wishing to refresh their knowledge of contemporary approaches to antimicrobial
therapy in Scotland.
The resource comprises a schedule of learning outcomes, an editable MS PowerPoint
training presentation and a CPD record of evidence of learning. All components are
available to download from the NES website.
For further information visit the NES website
http://www.nes.scot.nhs.uk/education-and-training/by-theme-initiative/healthcareassociated-infections/training-resources/antimicrobials-in-clinical-practice.aspx
Online Short Courses
There are a range of online modules available via learnPro and these include the
following:
Antibiotic Prescribing for Today’s Practitioner [logo]
The online module aims to heighten awareness of contemporary approaches to
antimicrobial management and issues relating to clinical effectiveness, patient safety
and the reduction of bacterial resistance.
There is a selection of e-learning vignettes for the learner to work through, based on a
wide range of different infections, presenting in a variety of settings. Each has an
estimated completion time of 20-40 minutes.
The target group includes medical prescribers in hospital and community settings; nonmedical prescribers including nurse practitioners, specialist nurses, community
pharmacists; clinical practitioners involved in administering and monitoring of antibiotic
treatment or management of infection; and members of Antimicrobial Management
Teams and infection control practitioners.
For further information visit the NES website
http://www.nes.scot.nhs.uk/education-and-training/by-theme-initiative/healthcareassociated-infections/online-short-courses/antibiotic-prescribing.aspx
Gentamicin and Vancomycin [logo]
These self directed online modules providing the most up-to-date national guidance to
support the safe and effective use of gentamicin and vancomycin in adults and are
based on the 2013 Scottish Antimicrobial Prescribing Group guidance. The target
groups for the modules are hospital prescribers including foundation year doctors and
non-medical prescribers and clinical practitioners involved in administering and
monitoring antibiotic treatment.
On completion of the modules learners will have an understanding of the requirements
for safe prescribing including calculating the initial dose, monitoring therapy (including
assessing for toxicity) and adjusting dosage regimens and the methods of
administration.
There are two gentamicin modules; one following the Hartford guidance and the other
following Greater Glasgow and Clyde guidance. There are two vancomycin modules;
one for intermittent infusion and one for continuous infusion. Modules are available via
learnPro and have been allocated to health boards based on the guidance adopted
locally in practice.
For further information visit the website
http://www.nes.scot.nhs.uk/education-and-training/by-theme-initiative/healthcareassociated-infections/online-short-courses/gav-gentamicin-and-vancomycin.aspx
Clostridium difficile [logo]
HAI online learning tutorial
This self-directed online tutorial describes the biology and epidemiology of Clostridium
difficile infection (CDI). It is aimed at a wide range of staff including specialist nurses,
antimicrobial management teams and consultant level physicians and surgeons. It will
improve the learner’s knowledge on the prevention, diagnosis and treatment of CDI, the
spectrum of disease and its presentation.
For further information visit the website
http://www.nes.scot.nhs.uk/education-and-training/by-theme-initiative/healthcareassociated-infections/online-short-courses/c-difficile-a-clinical-tutorial.aspx
Clostridium difficile [logo]
HAI online Clinical Scenario
This self-directed online module describes the appropriate clinical management of
Clostridium difficile infection (CDI) including infection control measures to the spread of
infection. The module portrays a clinical situation and the learner is asked questions
based on the management of an individual case. The module is aimed at a wide range
of staff including doctors at consultant, SpR and foundation level, infection control
teams, specialist nurses and clinical staff with an interest in the management of patients
with CDI.
For further information visit the website
http://www.nes.scot.nhs.uk/education-and-training/by-theme-initiative/healthcareassociated-infections/online-short-courses/c-difficile-a-clinical-scenario.aspx
Bacterial Resistance [logo]
HAI online learning tutorial
The Bacterial Resistance Tutorial is for clinical practitioners wishing to update their
knowledge of the principles of bacterial resistance or staff new to this topic wanting to
learn the principles of bacterial resistance and its clinical relevance.
For further information visit the website
http://www.nes.scot.nhs.uk/education-and-training/by-theme-initiative/healthcareassociated-infections/online-short-courses/bacterial-resistance.aspx
Promoting Hand Hygiene in Healthcare [logo]
This self-directed online resource is designed to be used by any healthcare worker,
student or carer within a hospital or community setting wishing to update, refresh or
challenge personal hygiene knowledge and practice.
For further information visit the website
http://www.nes.scot.nhs.uk/education-and-training/by-theme-initiative/healthcareassociated-infections/online-short-courses/hand-hygiene.aspx
Priorities for 2014-16
NES will continue to support the implementation, maintenance and evaluation of these
education resources and respond to emergent educational needs of NHSScotland as
identified by the SAPG and Scottish Government HAI Task Force.
Links
NHS Education for Scotland, Healthcare Associated Infection Education
http://www.nes.scot.nhs.uk/education-and-training/by-theme-initiative/healthcareassociated-infections.aspx
NHS Education for Scotland, Pharmacy Directorate
http://www.nes.scot.nhs.uk/education-and-training/by-discipline/pharmacy.aspx
Scottish Antimicrobial Prescribing Group (SAPG)
http://www.scottishmedicines.org.uk/SAPG/Scottish_Antimicrobial_Prescribing_Group__
SAPG_
Scottish Government Healthcare Associated Infection Task Force
http://www.scotland.gov.uk/Topics/Health/Services/Preventing-HealthcareInfections/Infection-Monitoring/Taskforce
UK Five Year Antimicrobial Resistance Strategy 2013-2018
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/244058/2
0130902_UK_5_year_AMR_strategy.pdf
The Scottish Management of Antimicrobial Resistance Action Plan (ScotMARAP)
http://www.scotland.gov.uk/Resource/Doc/215645/0057700.pdf