Improving antimicrobial stewardship in an Acute Medical Unit (AMU) during patient discharge following introduction of an Antimicrobial Information Card.

Background Patients who initially present to the emergency department are often streamlined to an Acute Medical Unit (AMU). A quality improvement project was developed to introduce a new “Antibiotic Information Card” for patients discharged home from the AMU. Aims were to reduce 30-day readmission and reattendance rates due to the same infection after initial discharge by 75%, as well as improving patient education regarding their antibiotic prescription to 75%. Methods Two Plan Do Study Act cycles were implemented in a busy AMU. Data were collected using electronic discharge software and patient records, as well as individual patient telephone questionnaires. Statistical analysis used run chart analysis. Results Baseline findings showed a variable level of patient knowledge on their antibiotic prescriptions (14%-70%) and fluctuations in 30-day reattendance rates (0%-50%). After the initial introduction of the Antibiotic Information Card, run chart analysis showed a shift in patient knowledge, significantly increasing to over 75%, and special cause variation which was not sustained. Discussion There were no significant changes in 30-day hospital reattendance and readmission rates throughout the intervention; however, there was a significant improvement in patient knowledge of their antibiotic prescription and management. Conclusions Staff engagement is encouraged for sustainability of quality improvement changes to promote antimicrobial stewardship within the AMU.