118 A useful adjunct to paper-based prescribing? An innovative clinical decision support tool which aids surgical antibiotic prophylaxis decision making

Abstract Introduction Compliance with surgical antimicrobial prophylaxis (SAP) is low in both Irish and European data. Clinical decision support tools are gaining popularity with the increasing use of electronic prescribing systems and present an opportunity for improvement in the area. Unfortunately, many institutions within Ireland remain without EPS. We aimed to trial a decision support tool, which provided a recommendation for SAP, without adjusting the current paper-based prescription process. Methods Existing data pertaining to SAP within the hospital group local antimicrobial guidelines was extracted. Algorithms were coded to produce a simple, quick and personalised SAP decision support tool which was available in a web-application format. The tool was trialed amongst anaesthetic staff at one hospital site over a four-week trial period. Staff who used the tool recorded the recommended SAP according to the tool as well as the recommended SAP according to pre-existing rudimentary guidelines. A post-hoc survey assessing usability of the innovation was conducted. Results Throughout the trial period the innovation provided the correct recommendation for SAP prescriptions when compared against existing SAP guidelines in 100% of instances recorded (164/164). Nine participants trialled the innovation. A post-hoc survey was completed by six participants. All participants reported a positive experience, furthermore they reported a desire to extend the innovation past the trial period. One user reported issues with internet connection. Benefits reported by participants included ‘simple’, ‘streamlined’ and ‘rapid’. Conclusion An opportunity exists to increase compliance with SAP prescribing by providing simple yet effective tools to prescribers.