Live Automated Microbiology Pharmacy surveillance

Healthcare Acquired Infections (HCAIs) are a key concern for all health organisations worldwide, resulting in significant patient morbidity and mortality. A fourteen-month outbreak of Clostridium difficile in the Northern Health and Social Care Trust led to an independent review of Trust policies and procedures in relation to HCAIs.  The main recommendations flowing from this review were to:

  • Develop a comprehensive infection surveillance system
  • Keep infection control and antimicrobial stewardship (AMS) policies under continual review and produce regular user-friendly reports
  • Provide monthly reports on action taken to promote sound AMS and achieve relevant performance indicators.

A multidisciplinary team was established to address these recommendations.  The team included microbiology consultants, pharmacists, infection control nurses and representatives from a local company, Yarra Software Ltd.  A new, bespoke solution for antimicrobial surveillance, Live Automated Microbiology Pharmacy Surveillance system (LAMPs) was developed.

Practical applications

Antimicrobial stewardship: Weekly audits of adherence to antimicrobial policies and the use of all restricted antibiotics within the Northern Health and Social Care Trust are entered by clinical pharmacy teams on the ward.  After validation of the data by both the antimicrobial pharmacist and microbiologist, the software produces various graphs.  These are available promptly for inclusion in quarterly reports for the Antimicrobial Management Team and Infection Prevention Control and Environmental Hygiene Committee.  The software automatically generates and emails an Excel spreadsheet of the data on a monthly basis to the antimicrobial pharmacist.  This facilitates production of stewardship reports to be made available to the ward Medical, Nursing and Pharmacy staff.

Intelligent alerts: Intelligent alerts are rules which are defined and can be modified by the user.  Alerts to the isolation of multi-drug resistant bacteria are set and an email is generated automatically by the system 24 hours a day, 365 days a year.  This email is sent to key recipients thereby enabling rapid remedial action to be taken.
Microbiology epidemiology: A live feed from laboratory software allows real time analysis of data, in particular organism sensitivity and resistance patterns to the antibiotic regimes being used.  This enables resistance trends to be identified and appropriate steps taken to address.
In the future the aim is to extend LAMPs across Northern Ireland in order to achieve a fully integrated surveillance system incorporating both primary and secondary care.