Improving surgical antimicrobial prescribing practice
Research type
Research Study
Full title
Understanding and improving surgical antimicrobial prescribing behaviour in the hospital setting: a service improvement project informed by ethnography
IRAS ID
291693
Contact name
Hazel Parker
Contact email
Sponsor organisation
Royal Devon University NHS Foundation Trust
Duration of Study in the UK
3 years, 9 months, 0 days
Research summary
Research shows that surgical teams (including surgeons, anaesthetists, junior doctors, pharmacists and nurses) do not always use antibiotics in the best way which can lead to unnecessary patient harm, for example antibiotic resistance and hospital acquired infections. We must improve surgical antibiotic prescribing but to be effective we must understand what influences practice.
This NIHR-funded project aims to improve antibiotic prescribing for surgical patients by working with surgical teams to introduce new ways of working that are informed by a deep understanding of the influences on their antibiotic prescribing practice.
The research has three sequential parts (over five years), with each informing the next:
1. Analysis of previous studies on surgical antibiotic prescribing has enabled us to see the ‘whole picture’ and to identify important research gaps to explore [complete].
2. Surgical teams from two NHS hospitals will be observed in the workplace, and surgical team members and patients will be interviewed, to explore influences on antibiotic prescribing decisions. Notes written during the observations and audio recordings from the interviews will be closely studied and analysed. This will lead to a deep understanding of what influences the surgical teams when they make antibiotic prescribing decisions and what might be workable in practice to modify the status quo, to improve practice.
3. Surgical team members from one NHS hospital will work together, with a researcher, to review current antibiotic prescribing practice (identified in part two). The group will design and introduce new ways of working, to improve antibiotic prescribing. Surgical wound infection rates and antibiotic prescribing will be monitored before and after the change, to assess the impact.While research with NHS staff does not necessarily require NHS REC approval, Phase II involves patient interviews; and Phase III involves researchers working with clinicians. Both phases will be published in peer-reviewed journals.
REC name
London - City & East Research Ethics Committee
REC reference
23/PR/0566
Date of REC Opinion
16 Jun 2023
REC opinion
Favourable Opinion