SFEBES2021 Poster Presentations Metabolism, Obesity and Diabetes (78 abstracts)
Leicestershire wide steroid safety programme 2019-21 and effectiveness of electronic alert on prescription software in a tertiary centre
Masato Ahsan 1 , Sajnin Zaman 1 , Roberta B Mifsud 2 , Narendra L Reddy 1,3 , Emma Bremner 1 , Mary Barrowcliffe 1 , Ragini C Bhake 1 & Miles J Levy 1,3
1University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; 2University of Malta, Malta, Malta; 3University of Leicester, Leicester, United Kingdom
Background: Omission of steroids and unsafe steroid prescription in Adrenal insufficiency (AI) patients during intercurrent illness or surgery is unfortunately common, and can lead to adrenal crisis and potentially death. Anna Mitchell et al, New Castle-upon-Tyne have demonstrated potential use of electronic automation with steroid alerts to minimise human error for ensuring patient safety.
Objectives: 1. Similar use of artificial intelligence was introduced in range of steroid safety measures in primary and secondary care settings with principle of ‘education at the point of care’.
2. To evaluate efficacy of electronic steroid alert in University Hospitals of Leicester’s (UHL) prescription software (EPMA).
Methodology & Results: Steroid safety measures undertaken are as below:
1. UHL emergency guideline for AI introduced in 2019.
1. EPMA alert is placed in prescribing software. 50 patients on hydrocortisone pre/- and post alert introduction (January 2019 and January 2020) were assessed with electronic and case note records to see the effectiveness of such an alert. Doubling of steroid doses and parenteral hydrocortisone for hypotensive patients improved from 28% to 68%.
1. Electronic alert placed on UHL’s patient handover software ‘Nervecentre’, which is used in Emergency department as well as on wards.
1. Primary care: Similar electronic alert was introduced in 2019 in primary care patient management software: ‘System one’ and ‘EMISS’:
1. NPSA mandatory steroid guidance and new NHS steroid cards introduced in all clinical areas of primary/secondary care from May 11th 2021.
Conclusion: 1. Electronic automation of point of care is potentially useful/life-saving and minimises human error in preventing omission of steroids.
2. Although the safe steroid prescription behavior improved significantly, to ensure alerts are acted upon, awareness needs to be brought about amongst clinicians and pharmacists by means of Trust communications, induction programs and mandatory training.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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