| Popis: |
Background: Anecdotal experience suggested there were areas for improvement in meningitis management. To address this, we conducted a complete audit cycle of the management of meningitis in adult patients at Arrowe Park Hospital. Method: We utilised the abbreviated audit tool from the McGill et al 2016 meningitis guidelines. Time period: 1/1/2017 to 31/12/2017. Cases audited: 20 A series of interventions were made. Time period for second cycle: 1/2/2019 to 31/5/2019. Cases audited: 6 Results: Audit standards were met for 1 out of 14 criteria for the first cycle and 2 out of 14 criteria for the second cycle. Of note, there was reasonable compliance with empiric choice of antibiotic (80% a 83%), definitive choice of antimicrobials (95% a83%) and duration of antimicrobials (84% a 100%). Improvements in investigations were seen in the second cycle: 1.Pneumococcal and Meningococcal EDTA PCR was sent (15% a 67%) 2.CSF glucose with concurrent plasma glucose sent (6.3% a 67%) 3.CSF for pneumococci and meningococci sent in all cases of suspected bacterial meningitis (22% a 67%) The re-audit identified no improvement in the following areas: 1.Blood cultures taken within 1 h of arrival at hospital (30% a 33%) 2.LP performed within 1 h of arrival at hospital provided that it is safe to do so (0% a 0%) 3.Antibiotics started within 1 hr of arrival in hospital (35% a 33%) In both audit cycles, 0% of patients were made aware of voluntary sector support. Conclusion: Whilst improvements were achieved, there remains considerable scope for further improvement. |
