Publications by authors named "Andrew Heed"
Article Synopsis
- - Antibiotic-resistant infections are a major global health concern, causing over 700,000 deaths annually, leading to the development of ePAMS+, an ePrescribing tool aimed at improving antibiotic usage and combating resistance in healthcare settings.
- - A non-randomised trial was conducted in two English hospitals during the pandemic to assess the feasibility and usability of ePAMS+, involving interviews and quantitative data collection to evaluate its implementation and effects on antibiotic prescribing practices.
- - Results from 60 interviews and nearly 2,000 patient admissions indicated some aspects of ePAMS+ were well-received, though improvements are needed for certain features, highlighting both the potential and challenges of adopting this antimicrobial stewardship tool in clinical settings.
Background: Antimicrobial resistance (AMR) represents a growing concern for public health.
Objective: We sought to explore the challenges associated with development and implementation of a complex intervention designed to improve AMS in hospitals.
Methods: We conducted a qualitative evaluation of a complex AMS intervention with educational, behavioral, and technological components in 5 wards of an English hospital.
Background: Antimicrobial resistance, the ability of microorganisms to survive antimicrobial drugs, is a public health emergency. Although electronic prescribing (ePrescribing)-based interventions designed to reduce unnecessary antimicrobial usage exist, these often do not integrate effectively with existing workflows. As a result, ePrescribing-based interventions may have limited impact in addressing antimicrobial resistance.
View Article and Find Full Text PDFBackground: Antimicrobial resistance is a leading global public health threat, with inappropriate use of antimicrobials in healthcare contributing to its development. Given this urgent need, we developed a complex ePrescribing-based Anti-Microbial Stewardship intervention (ePAMS+).
Methods: ePAMS+ includes educational and organisational behavioural elements, plus guideline-based clinical decision support to aid optimal antimicrobial use in hospital inpatients.
Objective: The medication administration process is complex and consequently prone to errors. Closed Loop Medication Administration solutions aim to improve patient safety. We assessed the impact of a novel medication scanning device (MedEye) on the rate of medication administration errors in a large UK Hospital.
View Article and Find Full Text PDFReducing prescribing errors: making electronic prescribing work for cystic fibrosis inpatients.
Arch Dis Child Educ Pract Ed
April 2023
Children admitted to our hospital with cystic fibrosis had frequent medication errors due to polypharmacy and addition of specialist and high-risk medications despite an electronic prescribing and medicines administration system in place. We describe a multidisciplinary quality improvement project that combined a computerised order entry system (CPOE) with human factor process changes. Over 12 months, our run chart showed a 43% reduction in prescription errors.
View Article and Find Full Text PDFBackground: WHO's Third Global Patient Safety Challenge, Medication Without Harm, focused on reducing the substantial burden of iatrogenic harm associated with medications by 50% in the next 5 years. We aimed to assess whether the number and type of medication errors changed as an electronic prescribing system was optimised over time in a UK hospital.
Methods: We did a prospective observational study at a tertiary-care teaching hospital.
Objectives: This study sought to identify the incidence of, and risk factors for, acute kidney injury (AKI) in adults treated with parenteral aciclovir.
Methods: A single-centre retrospective cohort study of prospectively acquired electronic clinical, pharmacy and laboratory data was performed with approval of the Caldicott guardian. AKI was defined by Kidney Disease Improving Global Outcomes (KDIGO) criteria, prior to analysis of baseline patient and treatment-related risk factors.
Background: Although the efficacy of computerized clinical decision support (CCDS) for acute kidney injury (AKI) remains unclear, the wider literature includes examples of limited acceptability and equivocal benefit. Our single-centre study aimed to identify factors promoting or inhibiting use of in-patient AKI CCDS.
Methods: Targeting medical users, CCDS triggered with a serum creatinine rise of ≥25 μmol/L/day and linked to guidance and test ordering.