Frequency of stepping down antibiotics and nebuliser treatment is lower at weekends compared to weekdays: an observational study

We hypothesised that delays in providing non-urgent medication step-downs at weekends to medical management may be associated with increased length of stay.In a novel use of electronic prescribing data, we analysed emergency admissions from a busy acute medical hospital over 52 weeks from November 2...

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Main Authors: Lewis, Sarah, Langley, Tessa, Lacey, Julia, Skelly, Rob, Norwood, Mark, Sturrock, Nigel, Fogarty, Andrew W.
Format: Article
Published: Royal College of Physicians 2017
Subjects:
Online Access:https://eprints.nottingham.ac.uk/48558/
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author Lewis, Sarah
Langley, Tessa
Lacey, Julia
Skelly, Rob
Norwood, Mark
Sturrock, Nigel
Fogarty, Andrew W.
author_facet Lewis, Sarah
Langley, Tessa
Lacey, Julia
Skelly, Rob
Norwood, Mark
Sturrock, Nigel
Fogarty, Andrew W.
author_sort Lewis, Sarah
building Nottingham Research Data Repository
collection Online Access
description We hypothesised that delays in providing non-urgent medication step-downs at weekends to medical management may be associated with increased length of stay.In a novel use of electronic prescribing data, we analysed emergency admissions from a busy acute medical hospital over 52 weeks from November 2014 to October 2015. The main outcomes of interest were switching from intravenous antibiotics to oral antibiotics and stopping nebulised bronchodilators. The rate of switching from intravenous to oral antibiotics was lower on Saturdays and Sundays compared with weekdays, and the rate of stopping nebulised bronchodilators was similarly lower at weekends (p<0.001). Median length of stay was shorter in those whose antibiotic treatment was stepped down at weekends compared with weekdays (4 days versus 5 days, p<0.001). Reduced medication step-downs at weekends may represent a bottleneck in patient flow. Electronic prescribing data are a valuable resource for future health services research.
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spelling nottingham-485582024-08-15T15:25:34Z https://eprints.nottingham.ac.uk/48558/ Frequency of stepping down antibiotics and nebuliser treatment is lower at weekends compared to weekdays: an observational study Lewis, Sarah Langley, Tessa Lacey, Julia Skelly, Rob Norwood, Mark Sturrock, Nigel Fogarty, Andrew W. We hypothesised that delays in providing non-urgent medication step-downs at weekends to medical management may be associated with increased length of stay.In a novel use of electronic prescribing data, we analysed emergency admissions from a busy acute medical hospital over 52 weeks from November 2014 to October 2015. The main outcomes of interest were switching from intravenous antibiotics to oral antibiotics and stopping nebulised bronchodilators. The rate of switching from intravenous to oral antibiotics was lower on Saturdays and Sundays compared with weekdays, and the rate of stopping nebulised bronchodilators was similarly lower at weekends (p<0.001). Median length of stay was shorter in those whose antibiotic treatment was stepped down at weekends compared with weekdays (4 days versus 5 days, p<0.001). Reduced medication step-downs at weekends may represent a bottleneck in patient flow. Electronic prescribing data are a valuable resource for future health services research. Royal College of Physicians 2017-12-01 Article PeerReviewed Lewis, Sarah, Langley, Tessa, Lacey, Julia, Skelly, Rob, Norwood, Mark, Sturrock, Nigel and Fogarty, Andrew W. (2017) Frequency of stepping down antibiotics and nebuliser treatment is lower at weekends compared to weekdays: an observational study. Clinical Medicine, 17 (6). pp. 504-507. ISSN 1473-4893 antibiotics; efficiency; healthcare delivery; length of stay; nebulisers; weekend effect http://www.clinmed.rcpjournal.org/content/17/6/504 doi:10.7861/clinmedicine.17-6-504 doi:10.7861/clinmedicine.17-6-504
spellingShingle antibiotics; efficiency; healthcare delivery; length of stay; nebulisers; weekend effect
Lewis, Sarah
Langley, Tessa
Lacey, Julia
Skelly, Rob
Norwood, Mark
Sturrock, Nigel
Fogarty, Andrew W.
Frequency of stepping down antibiotics and nebuliser treatment is lower at weekends compared to weekdays: an observational study
title Frequency of stepping down antibiotics and nebuliser treatment is lower at weekends compared to weekdays: an observational study
title_full Frequency of stepping down antibiotics and nebuliser treatment is lower at weekends compared to weekdays: an observational study
title_fullStr Frequency of stepping down antibiotics and nebuliser treatment is lower at weekends compared to weekdays: an observational study
title_full_unstemmed Frequency of stepping down antibiotics and nebuliser treatment is lower at weekends compared to weekdays: an observational study
title_short Frequency of stepping down antibiotics and nebuliser treatment is lower at weekends compared to weekdays: an observational study
title_sort frequency of stepping down antibiotics and nebuliser treatment is lower at weekends compared to weekdays: an observational study
topic antibiotics; efficiency; healthcare delivery; length of stay; nebulisers; weekend effect
url https://eprints.nottingham.ac.uk/48558/
https://eprints.nottingham.ac.uk/48558/
https://eprints.nottingham.ac.uk/48558/