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Publisher: Oxford University Press
Journal: Journal of Antimicrobial Chemotherapy
Languages: English
Types: Article
Subjects: antimicrobial management, technology adoption, Original Research, RC0254, decision support, T1, eHealth
Objectives: Smartphone usage amongst clinicians is widespread. Yet smartphones are not widely used for the dissemination of policy or as clinical decision support systems. We report here on the development, adoption and implementation process of the Imperial Antimicrobial Prescribing Application across five teaching hospitals in London.\ud \ud Methods: Doctors and clinical pharmacists were recruited to this study, which employed a mixed methods indepth case-study design with focus groups, structured pre- and post-intervention survey questionnaires and live data on application uptake. The primary outcome measure was uptake of the application by doctors and its acceptability. The development and implementation processes were also mapped.\ud \ud Results: The application was downloaded by 40% (376) of junior doctors with smartphones (primary target user group) within the first month and by 100% within 12 months. There was an average of 1900 individual access sessions per month, compared with 221 hits on the Intranet version of the policy. Clinicians (71%) reported that using the application improved their antibiotic knowledge.\ud \ud Conclusions: Clinicians rapidly adopted the mobile application for antimicrobial prescribing at the point of care, enabling the policy to reach a much wider audience in comparison with paper- and desktop-based versions of the policy. Organizations seeking to optimize antimicrobial prescribing should consider utilizing mobile technology to deliver point-of-care decision support. The process revealed a series of barriers, which will need to be addressed at individual and organizational levels to ensure safe and high-quality delivery of local policy at the point of care.
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1 Davey P, Brown E, Fenelon L et al. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database Syst Rev 2005; issue 4: CD003543.
    • 2 Charani E, Edwards R, Sevdalis N et al. Behaviour change strategies to influence antimicrobial prescribing: a systematic review. Clin Infect Dis 2011; 53: 651-62.
    • 3 Bates DW, Gawande AA. Improving safety with information technology. N Engl J Med 2003; 348: 2526-34.
    • 4 Baldwin LP, Low PH, Picton C et al. The use of mobile devices for information sharing in a technology-supported model of care in AE. Int J Electron Healthc 2006; 3: 90-106.
    • 6 Oehler RL, Smith K, Toney JF. Infectious diseases resources for the iPhone. Clin Infect Dis 2010; 50: 1268- 74.
    • 7 Baumgart DC. Personal digital assistants in health care: experienced clinicians in the palm of your hand? Lancet 2005; 366: 1210- 2.
    • 8 Aziz O, Panesar SS, Netuveli G et al. Handheld computers and the 21st century surgical team: a pilot study. BMC Med Inform Decis Mak 2005; 5: 28.
    • 9 US FDA. Draft Guidance for Industry and Food and Drug Administration Staff-Mobile Medical Applications. 21 July 2011. http://www.fda.gov/ medicaldevices/deviceregulationandguidance/guidancedocuments/default. htm (6 November 2012, date last accessed).
    • 18 Kyratsis Y, Ahmad R, Holmes A. Technology adoption and implementation in organisations: comparative case studies of 12 English NHS Trusts. BMJ Open 2012; 2: e000872.
    • 19 Yin R. Case Study Research - Design and Methods. London: Sage, 2003.
    • 20 Pope C, Ziebland S, Mays N. Analysing qualitative data. BMJ 2000; 320: 114 - 6.
    • 21 Department of Health. Technology Review Number 6. https://www.wp. dh.gov.uk/publications/files/2012/08/Local-Tecnology-Review-Reportnumber-6.pdf (06 November 2012, date last accessed).
    • 22 Gill PS, Kamath A, Gill TS. Distraction: an assessment of smartphone usage in health care work settings. Risk Manag Healthc Policy 2012; 5: 105 - 14.
    • 10 European Commission. Medical Devices Guidance Documents. http: //ec.europa.eu/health/medical-devices/documents/guidelines/index_en.htm (6 November 2012, date last accessed). 23 Visvanthan A, Hamilton A, Brady RRW. Smartphone apps in microbiology- is better regulation required? Clin Microbiol Infect 2012; 18: E218- 20.
    • 11 Putzer GJ, Park Y. Are physicians likely to adopt emerging mobile technologies? Attitudes and innovation factors affecting smartphone use in the south-eastern United States. Perspect Health Inf Manag 2012; 9: 1b.
    • 12 Mosa AS, Yoo I, Sheets L. A systematic review of healthcare applications for smartphones. BMC Med Inform Decis Mak 2012; 12: 67.
    • 13 Catwell L, Sheikh A. Evaluating eHealth interventions: the need for continuous systemic evaluation. PLoS Med 2009; 6: e1000126.
    • 14 University of Cambridge. Mobile Communications for Medical Care: A Study of Current and Future Healthcare and Health Promotion Applications, and Their Use in China and Elsewhere. http://www.csap.cam. ac.uk/media/uploads/files/1/mobile-communications-for-medical-care.pdf (6 November 2012, date last accessed).
    • 15 Black AD, Car J, Pagliari C et al. The impact of eHealth on the quality and safety of health care: a systematic overview. PLoS Med 2011; 8: e1000387.
    • 16 McAlearney AS, Chisolm DJ, Schweikhart S et al. The story behind the story: physician scepticism about relying on clinical information technologies to reduce medical errors. Int J Med Inform 2007; 76: 836 - 42.
    • 17 Rogers EM. Diffusion of Innovations. New York: Free Press, 2003.
    • 24 Brady RR, Wasson A, Stirling I et al. Is your phone bugged? The incidence of bacteria known to cause nosocomial infection on healthcare workers' mobile phones. J Hosp Infect 2006; 62: 123 - 5.
    • 25 Borer A, Gilad J, Smolyakov R. Cell phones and Acinetobacter transmission. Emerg Infect Dis 2005; 11: 1160- 1.
    • 26 Wilson JA, Loveday HP, Hoffman PN et al. Uniform: an evidence review of the microbiological significance of uniforms and uniform policy in the prevention and control of healthcare-associated infections. Report to the Department of Health (England). J Hosp Infect 2007; 66: 301 - 7.
    • 27 Bhusal Y, Laza S, Lande TW et al. Bacterial colonization of wristwatches worn by healthcare personnel. Am J Infect Control 2009; 27: 476 - 7.
    • 28 Perry C, Marshall R, Jones E. Bacterial contamination of uniforms. J Hosp Infect 2001; 48: 238 - 41.
    • 29 Teare L, Cookson B, Stone S. Hand hygiene. Use alcohol hand rubs between patients: they reduce the transmission of infection. BMJ 2008; 323: 411 - 2.
    • 30 Klakus J, Vaughan NL, Boswell TC. Meticillin-resistant Staphylococcus aureus contamination of hospital curtains. J Hosp Infect 2008; 68: 189 - 90.
  • Inferred research data

    The results below are discovered through our pilot algorithms. Let us know how we are doing!

    Title Trust
    67
    67%
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