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J Educ Eval Health Prof. 2017 Jun 7. doi: 10.3352/jeehp.2017.14.13. [Epub ahead of print]

Junior doctors' preparedness to prescribe, monitor and treat patients with the antibiotic vancomycin in an Australian teaching hospital.

Author information

1
Department of Pharmacy, Flinders Medical Centre, Bedford Park, SA, 5042, Australia.
2
School of Medicine, Flinders University, Adelaide, SA, 5000, Australia.
3
School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, 5000, Australia.
4
Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, SA, 5000, Australia.
5
Flinders Centre for Epidemiology and Biostatistics, School of Medicine, Flinders University, Adelaide, Australia.
6
SA Pathology, Microbiology and Infectious Diseases, Flinders Medical Centre, Bedford Park, SA 5042, Australia.
7
Division of Medicine, Flinders Medical Centre, Bedford Park, SA 5042, Australia.

Abstract

Purpose:

We aimed to assess preparedness of junior doctors to use vancomycin, and determined association between education and provision of a pocket guideline on self-reported confidence and objective knowledge.

Methods:

This was a two component cross-sectional study. A sixty-minute educational session and provision of a pocket guideline were implemented. Preparedness was evaluated by self-reported confidence survey in early and late stages of each training year, and by continuing medical education (CME) knowledge scores.

Results:

Self-confidence was higher for those later in the training year (n=75) compared to those earlier (n=120) in the year for all questions. In the late group, vancomycin education was associated with higher self-confidence regarding frequency of therapeutic drug monitoring (p=0.02) and dose amendment (p=0.05), however confidence for initial monitoring was lower (p=< 0.005). Those with a pocket guideline were more confident treating patients with vancomycin (p=<0.001), choosing initial (p=0.01) and maintenance doses (p=<0.001), and knowing monitoring frequency (p=0.03). Eighty-five respondents completing the knowledge assessment scored a mean (SD) of 8.55 (1.55) from 10 questions with the interventions having no significant effect.

Conclusions:

Attending an educational session and possessing a pocket guideline were associated with preparedness measured by higher self-reported confidence using vancomycin. High knowledge scores were attained following CME, however attending education or possessing a pocket guideline did not significantly increase knowledge scores. Our findings support education and provision of pocket guideline to increase self-confidence to prescribe vancomycin, yet highlight importance of evaluating content, format and delivery when seeking to improve preparedness to use vancomycin through education.

KEYWORDS:

Drug Monitoring; Drug Prescriptions; Medical Staff, Hospital; Vancomycin

PMID:
28669145
DOI:
10.3352/jeehp.2017.14.13
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