Antimicrobial Stewardship Velindre Cancer Centre Judy Banfield Lead

Antimicrobial Stewardship @ Velindre Cancer Centre Judy Banfield Lead Pharmacist for Antimicrobial Stewardship Dr Rishi Dhillon Consultant Microbiologist Public Health Wales

Velindre Cancer Centre Cardiff

Strategies we’ve used to address and decrease antibiotic resistance @ VCC • Use of ongoing education • Use of evidence-based hospital guidelines: • Antimicrobial guidelines • Neutropenic Sepsis guidelines • Management of Diarrhoea caused by Clostridium difficile Infection (CDI) and Chemotherapy Toxicity • Establishment of the Antimicrobial Management Team and a Sepsis working group • Consultant Microbiologist ward rounds

VCC Hospital Acquired Infections § C. difficile § MRSA bacteraemia § MSSA bacteraemia

Microbiology Services • Since September 2014 • • Weekly abx ward rounds established Me, abx pharmacist, IC nurse Medics involved on each ward List of pts drawn up by team and any others medics/nurses want to discuss • Continuity key

Total number of interventions Continue Review advice Investigation advice Duration advice Start Stop IV to PO Dose adjustment Switch Total number of ward rounds 68 Total number of patients 394 Continue 148 Review advice 23 Investigation advice 45 Duration advice 29 Start 15 Stop 53 IV to PO 19 Dose adjustment 9 Switch 45

How useful do you find the microbiology ward round? Very useful Quite useful Neither positive or negative Unhelpful Very unhelpful • This has been a vitally important addition to patient care and management • Not been involved directly • Although a patient the other day got put on 3 antibiotics when she was dying. It didn't feel as if the whole picture was looked at. • Have only seen one microbiology ward round in the last 2 months • I think this helps the team and optimises pt management • Brilliant for teaching and development

Message from Velindre NHS Trust’s Chief Executive Steve Ham https: //www. youtube. com/watch? v=NE 1 t 7 i. Fc_G 4