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Junior doctors' preparedness to prescribe, monitor, and treat patients with the antibiotic vancomycin in an Australian teaching hospital.

ABSTRACT: PURPOSE:We aimed to assess the preparedness of junior doctors to use vancomycin, and to determine whether attending an educational session and being provided pocket guidelines were associated with self-reported confidence and objective knowledge. METHODS:This was a 2-component cross-sectional study. A 60-minute educational session was implemented and pocket guidelines were provided. Preparedness was evaluated by a self-reported confidence survey in the early and late stages of each training year, and by continuing medical education (CME) knowledge scores. RESULTS:Self-confidence was higher among those later in the training year (n=75) than in those earlier (n=120) in the year for all questions. In the late group, vancomycin education was associated with higher self-confidence regarding the frequency of therapeutic drug monitoring (P=0.02) and dose amendment (P=0.05); however, the confidence for initial monitoring was lower (P<0.05). Those with pocket guidelines were more confident treating patients with vancomycin (P<0.001), choosing initial (P=0.01) and maintenance doses (P<0.001), and knowing the monitoring frequency (P=0.03). The 85 respondents who completed the knowledge assessment scored a mean±standard deviation of 8.55±1.55 on 10 questions, and the interventions had no significant effect. CONCLUSION:Attending an educational session and possessing pocket guidelines were associated with preparedness, as measured by higher self-reported confidence using vancomycin. High knowledge scores were attained following CME; however attending an educational session or possessing pocket guidelines did not significantly increase the knowledge scores. Our findings support providing educational sessions and pocket guidelines to increase self-confidence in prescribing vancomycin, yet also highlight the importance of evaluating content, format, and delivery when seeking to improve preparedness to use vancomycin through education.

SUBMITTER: Phillips CJ

PROVIDER: S-EPMC5549022 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Junior doctors' preparedness to prescribe, monitor, and treat patients with the antibiotic vancomycin in an Australian teaching hospital.

Phillips Cameron J CJ McKinnon Ross A RA Woodman Richard J RJ Gordon David L DL

Journal of educational evaluation for health professions 20170607

<h4>Purpose</h4>We aimed to assess the preparedness of junior doctors to use vancomycin, and to determine whether attending an educational session and being provided pocket guidelines were associated with self-reported confidence and objective knowledge.<h4>Methods</h4>This was a 2-component cross-sectional study. A 60-minute educational session was implemented and pocket guidelines were provided. Preparedness was evaluated by a self-reported confidence survey in the early and late stages of eac ...[more]

PMID: 28669145

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Project description:IntroductionIn university hospital settings most prescriptions are written by junior doctors, who are more likely to make prescribing errors than experienced doctors. Prescribing errors can cause serious harm to patients and drug harm differs among low, middle and high-income countries. In Brazil, few studies have investigated the causes of these errors. Our aim was to explore medication prescribing errors in a teaching hospital, their causes, and underlying factors from the perspective of junior doctors.MethodQualitative, descriptive and exploratory study that used a semi-structured individual interview with questions related to the planning and execution of prescriptions. It was conducted with 34 junior doctors who graduated from twelve different universities located in six Brazilian states. The data were analyzed according to the Reason's Accident Causation model.ResultsAmong the 105 errors reported, medication omission stood out. Most errors resulted from unsafe acts during execution, followed by mistakes and violations. Many errors reached the patients; unsafe acts of rule violations and slips accounted for the majority. Work overload and time pressure were the most frequently reported causes. Difficulties faced by the National Health System and organizational problems were identified as latent conditions.ConclusionThe results reaffirm international findings about the severity of prescribing errors and the multifactorial aspect of their causes. Unlike other studies, we found a large number of violations, which, from the interviewees' perspectives, are related to socioeconomic and cultural patterns. The violations were not seen or mentioned by the interviewees as violations, but as difficulties in accomplishing their tasks on time. Knowing these patterns and perspectives is important for implementing strategies to improve the safety of both patients and professionals involved in the medication process. It is suggested that the exploitation culture of junior doctors' work be discouraged and that their training be improved and prioritized.

Dataset Information

Junior doctors' preparedness to prescribe, monitor, and treat patients with the antibiotic vancomycin in an Australian teaching hospital.

Publications

Junior doctors' preparedness to prescribe, monitor, and treat patients with the antibiotic vancomycin in an Australian teaching hospital.

Similar Datasets

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