Using a simple handover to improve the timing of gentamicin levels

Williamson, A., Bradley, A. and Khan, K. (2015) Using a simple handover to improve the timing of gentamicin levels. BMJ Quality Improvement Reports, 4(1), u207727.w3081. (doi: 10.1136/bmjquality.u207727.w3081) (PMID:26734400) (PMCID:PMC4693051)

Abstract

The aminoglycoside gentamicin is commonly used in many NHS trusts to cover gram negative organisms in intra-abdominal sepsis and sepsis of unknown origin. As a result it often forms an important part of thew "Sepsis 6" protocol on surgical wards. Despite it's effectiveness, the antibiotic is well known to have nephrotoxic and ototoxic side effects, making monitoring of serum levels vital. In Hairmyres Hospital, a busy district general hospital in Lanarkshire, levels are typically taken at six to 14 hour post-dose intervals, with the result guiding further gentamicin dosing. A baseline measurement was performed highlighting that 42.2% of these levels were taken after the 14 hour limit. This was thought to have serious implications for patient's, as levels designed to protect them from side effects whilst maintain g an effective antimicrobial action were not being performed properly. As a result, a "gentamicin handover" was introduced to the wards in order to ease the workload on junior staff and improve handover between teams. During our short project the number of late levels initially dropped to 33.3% after one week, falling further to 28.6% following the second week of intervention. From our results it is clear that while more intervention is required gentamicin prescription, this project highlights how a simple intervention to improve ward handover can create a very noticeable improvement in the quality of patient care within a small time period.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Khan, Mr Khurram
• Authors: Williamson, A., Bradley, A., and Khan, K.
• College/School: College of Medical Veterinary and Life Sciences > School of Cancer Sciences; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: BMJ Quality Improvement Reports
• Publisher: BMJ Publishing Group
• ISSN: 2050-1315
• ISSN (Online): 2050-1315
• Copyright Holders: Copyright © 2015 The Authors
• First Published: First published in BMJ Quality Improvement Reports 4(1):u207727.w3081
• Publisher Policy: Reproduced under a Creative Commons license