the obese patient: a 3-cycle drug chart and case note audit

SummaryObjectives To assess the use of an electronic dose calculator toimprove accuracy in the use of a complex Gentamicin prescription policyand assessturnaround time of blood sampling to dose delivery in an NHShospital.Design Retrospective review of drug chart, case notes and hospitalantibiotic database.Setting University Hospitals Bristol, UKParticipants Patients receiving once daily intravenous gentamicinusing the trust protocol, during the same time window for 3 consecutiveyears.Main outcome measures i) Accuracy of dose and frequencyprescription of Gentamicin. ii) Time frame for measurement of serumGentamicin levels.Results Following the introduction of the online calculator, prescribingerrors in obese patients dropped from 43% to 20%, a similar level as innon-obese patients. Errors in frequency calculations dropped from 12.8%to4%.Onaverage, drug doses couldbeadministeredwithin2.5 hours ofablood sample being taken.Conclusions Online tools can be used to improve prescribing for thecomplex dosing policies that will increasingly been required to tailorprescribing in obese patients. Serum gentamicin levels can be measuredwithin a 2.5 hour time frame in the environment of an NHS hospital.