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Lack of weight recording in patients being administered narrow therapeutic index antibiotics: a prospective cross-sectional study

Title: Lack of weight recording in patients being administered narrow therapeutic index antibiotics: a prospective cross-sectional study
Author(s): Charani, E
Gharbi, M
Hickson, M
Othman, S
Alfituri, A
Frost, G
Holmes, A
Item Type: Journal Article
Abstract: Objectives Patient weight is a key measure for safe medication management and monitoring of patients. Here we report the recording of patient's body weight on admission in three hospitals in West London and its relationship with the prescription of antibiotic drugs where it is essential to have the body weight of the patient. Methods A prospective cross-sectional study was conducted in three teaching hospitals in West London. Data were collected during March 2011–September 2011 and July 2012–August 2012, from adult admissions units, medical and surgical wards. Data from each ward were collected on a single day to provide a point prevalence data on weight recording. Patient medication charts, nursing and medical notes were reviewed for evidence of weight and height recording together with all the medication prescribed for the patients. An observational study collecting data on the weight recording process was conducted on two randomly selected wards to add context to the data. Results Data were collected on 1012 patients. Weight was not recorded for 46% (474) of patients. Eighty-nine patients were prescribed a narrow therapeutic antibiotic, in 39% (35/89) of these weight was not recorded for the patient. Intravenous vancomycin was the most commonly prescribed antibiotic requiring therapeutic monitoring. In total 61 patients were receiving intravenous vancomycin and of these 44% (27/61) did not have their weight recorded. In the observational study, the most frequently identified barrier to weight not being recorded was interruptions to the admission process. Conclusions Despite the clinical importance of body weight measurement it is poorly recorded in hospitalised patients, due to interruptions to the workflow and heavy staff workloads. In antibiotics a correct, recent patient weight is required for accurate dosing and to keep drugs within the narrow therapeutic index, to ensure efficacy of prescribing and reduce toxicity.
Publication Date: 2-Apr-2015
Date of Acceptance: 13-Oct-2014
URI: http://hdl.handle.net/10044/1/41646
DOI: http://dx.doi.org/10.1136/bmjopen-2014-006092
ISSN: 2044-6055
Publisher: BMJ Publishing Group
Journal / Book Title: BMJ Open
Volume: 5
Issue: 4
Sponsor/Funder: Medical Research Council (MRC)
The Pharmacy Practice Research Trust
Funder's Grant Number: G0800777
N/A
Copyright Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Keywords: Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
MALNUTRITION
INPATIENTS
HEIGHT
IMPACT
THERAPEUTICS
Adolescent
Adult
Aged
Anti-Bacterial Agents
Body Weight
Cross-Sectional Studies
England
Female
Hospitals, Teaching
Humans
Male
Medical Records
Middle Aged
Nursing Records
Practice Patterns, Physicians'
Prospective Studies
Young Adult
Humans
Body Weight
Anti-Bacterial Agents
Medical Records
Nursing Records
Prospective Studies
Cross-Sectional Studies
Adolescent
Adult
Aged
Middle Aged
Hospitals, Teaching
England
Female
Male
Young Adult
Practice Patterns, Physicians'
Publication Status: Published
Article Number: e006092
Appears in Collections:Department of Medicine
Faculty of Medicine
Epidemiology, Public Health and Primary Care



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