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13. Action Plan: Prescribers' Individual Responsibilities
Patient safety and quality of care is the personal responsibility of each prescriber.
The prevalence of antimicrobial resistant bacteria is partly governed by antimicrobial usage and the ability of bacteria to spread through the environment. Healthcare environments are particularly prone to bacterial spread. Antimicrobials are used more often here than in other environments and individual patients are cared for by staff working in this enclosed environment.
Infection prevention and control is an essential part of preventing the spread of antimicrobial resistance and guidelines developed by the Healthcare Associated Infection Task Force should always be followed 17, 19, 20. A plan of action for combating the development of antimicrobial resistance must include measures that deter the spread of bacteria in general - and antimicrobial resistant strains in particular - both in hospitals and in care homes.
Prudent prescribing following local and national guidelines in line with local formularies should be encouraged and actively managed as a matter of good clinical governance. All antimicrobial prescribers, including supplementary and independent prescribers, should have specific continuing professional development ( CPD) objectives related to antimicrobial prescribing, antimicrobial resistance patterns and healthcare associated infections, which is mandatory in the NHSScotland Code of Practice for the Management of Hygiene and Healthcare Associated Infection3. Each prescriber should update their knowledge in this area on a regular basis, usually annually in the case of trainee prescribers.
Reorganisations in the health service aimed at staff efficiencies and higher patient throughputs have led to greater mobility of patients between different wards during single episodes of hospitalisation. While there may be operational reasons for this, patient movements inevitably carry a risk of spreading infection with antimicrobial resistant organisms. This risk must be weighed against the clinical requirements for moving patients within a hospital.
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