Domain 2:

Safety and Quality: Audit

Example 1 - Antibiotics (5 or 8 criterion audit)

As an OOH doctor you will often see a high proportion of patients presenting for unscheduled care with specific needs such as infections. Your prescribing will reflect this, but it is important to be able to demonstrate good practice in antibiotic usage.

For one hundred serial consultations, note those in which you prescribe a certain class of drug and compare this against your chosen set of criteria and standards. You need to consider defining criteria and setting standards for topics such as:

  1. The proportion of your consultations that resulted in antibiotic prescriptions should be similar to the mean for your colleagues (identify and reflect on exceptions)
  2. Patients receiving antibiotics should have a recognised condition for which antibiotics are recommended
  3. Antibiotics should be used which are in line with local formulary or microbiology laboratory recommendations for first line use, unless clinically contraindicated
  4. When appropriate, microbiology sampling should be undertaken to check on organisms and sensitivities prior to commencing antimicrobial therapy
  5. All antibiotic prescribing should use the most effective dose and duration of treatment for the identified condition, in line with local formulary guidelines or the BNF
  6. All antibiotic prescribing should be accompanied by a recorded check for known past history of hypersensitivity
  7. All antibiotic prescribing should be accompanied by a check for potential drug interactions
  8. Broad spectrum antibiotics should only be used where clinically indicated
  9. If a second line antibiotic is used, the reason for its use should be documented
  10. All potentially infective lesions or conditions should be subject to local infection control policies
  11. Patients with MRSA should be handled in line with agreed local guidelines

This page was last updated on: 18/08/2016