Collaborative to improve the
use of antimicrobials in children.

Protocol

FAQs

Question: We have a patient admitted for a “CF exacerbation” who is on azithromycin for "anti-inflammatory purposes". What do we chose in "reason for treatment"? We've selected "other", but would like to hear your opinion. Also, what do we pick in "empirical or targeted treatment"?

Answer: I think other or prophylaxis works. I would pick empirical. Could also consider selecting 'not used for prophylactic or treatment purposes' for the "Indication for Treatment question"


Question: Do you consider well controlled asthma a chronic lung disease:

Answer: Yes, as it probably still impacts therapy


Question: Should I consider our cystic fibrosis unit to be general PMW or other PMW?

Answer: Other, since it is dedicated to CF


Question: We would like to work on the data extraction/entry over several days during the survey period. What should we do if a patient in the PICU today and a general pediatrics unit 2 days from now? Will it be confusing if we have the same patient move units in between surveys?

Answer: We have decided if you spread the survey out over a few days that we would go ahead and record a patient twice. So it is possible that you could enter data on a patient while they are in the PICU on Monday and then again on Wednesday when they are on the floor if you run a floor specific report on different days. While ideally we would like that to not happen, but we don’t want you all to have to worry about distinguishing if you had reviewed a patient previously especially if you spread the survey out over some time. Now you could run a report of all patients on Monday and then input the data over the next couple of days. That is okay, but be aware of be aware of allowing the information on the two additional days influencing your data collection.


Question: It was my understanding that the survey did not have to be completed all in one day, but that a unit started one a certain day needs to be finished on that same day. Is this correct?

Answer: Yes, you are correct. It is highly unlikely you would be able to complete the survey on every unit in your hospital in one day.


Question: We are unclear as to if we should be opening up a patient record for a patient who is not on antibiotics, and answering NO to the first question. We did this and it created a blank drug form for those patients. I think answering “no” to the question is the right decision, but confused as to why it creates a drug form for that patient?

Answer: There is no need to complete a patient form for patients not on any antimicrobials. We put that qualifying question at the beginning of the form just to help ensure users don't spend time entering patient data for an "ineligible" record.


Question: After taking a snapshot of our PICU at 0800 today, I realized we are not capturing PICU inpatients who may be in OR or PACU at the time of the snapshot… is this acceptable?

Answer: PICU patients that are in the OR and PACU that are admitted to the PICU should count. It is those patients that maybe are in the ED and not yet admitted that don’t count.


Question: Do you want the age to state the total years, total months, and total days OR do you want the age in years then months then days – for example, if a patient is 3 years, 9 months, and 26 days old, should we write this OR do we write 3 years, 45 months, 1395 days?

Answer: We want 3 years, 9 months and 26 days.


Question: If the patient is on tmp-smx bid only Sat and Sunday. What should be the interval recorded? Should I select q12 or other?

Answer: Select “other”


Question: I know the manual says to mark the answer to “empirical or targeted” as “empirical with no cultures performed” for surgical prophylaxis. Should I be answering “empirical with no cultures performed” for any prophylaxis antibiotics, UTI or otherwise?

Answer: I would keep putting empirical without culture. I think in the end we will have to consider how this data is analyzed because it is a little odd.


Wash U Med School St Louis Childrens