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Prescribing in a pandemic: Electronic prescribing aids to improve non-specialist adherence to COVID-19 guidelines

Woodman, M; Salkeld, J; Sharrock, C; Alice Oborne, C; Nguyen, H; Sobti, A; Goodman, AL; (2023) Prescribing in a pandemic: Electronic prescribing aids to improve non-specialist adherence to COVID-19 guidelines. Clinical Infection in Practice , 19 , Article 100223. 10.1016/j.clinpr.2023.100223. Green open access

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Abstract

Introduction: The evidence around COVID-19 management is continuously evolving. Ensuring awareness of, and adherence to current guidance is challenging. As the second wave of COVID-19 emerged, we recognised the urgent need for better standardisation of patient care in the context of increasing patient load and acuity and the resulting redeployment of staff. Methods: COVID-19 patients admitted to adult medical wards were identified via their positive swab results. An e-prescribing protocol which included five drugs was introduced and adherence to prescribing guidelines assessed via the electronic noting and prescribing system. Doctors’ views of the prescribing protocol were assessed. Results: Following introduction of the protocol, adherence to guidelines improved. The proportion of patients either prescribed dexamethasone or with a valid contraindication documented increased from 85% to 97% and for remdesivir this increased from 60% to 79%. There was also significant improvement in the prescription of ‘as required’ insulin for patients on steroids (26% to 48%) and oxygen (43% to 79%). 93% of doctors surveyed were aware of the e-prescribing protocol and 81% had used it. Confidence in adhering to the protocols increased from an average of 3.3 to 4.5 out of 5 and 93% of respondents agreed that the protocol was easy to use. Discussion: Overall, this demonstrates that electronic prescribing protocols can be effective in increasing adherence to guidelines and doctors felt this was a useful tool. This is especially important in a pandemic situation in which many doctors were redeployed outside of their usual specialties.

Type: Article
Title: Prescribing in a pandemic: Electronic prescribing aids to improve non-specialist adherence to COVID-19 guidelines
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.clinpr.2023.100223
Publisher version: https://doi.org/10.1016/j.clinpr.2023.100223
Language: English
Additional information: © 2023 Published by Elsevier Ltd on behalf of British Infection Association. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Keywords: Bundle, COVID-19, E-prescribing, Protocol, SARS-CoV-2, Technology
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL
URI: https://discovery.ucl.ac.uk/id/eprint/10184124
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