Alam, Ali M 
ORCID: 0000-0001-6014-3263, Lester, Rebecca, Hoyle, Marie-Claire, Fletcher, Tom E and Hine, Paul
(2022)
Increasing anti-S antibody testing: a quality improvement initiative with evolving COVID-19 guidelines.
BMJ open quality, 11 (3).
e001886-e001886.
Abstract
<h4>Background</h4>COVID-19 management guidelines are constantly evolving, making them difficult to implement practically. <i>Ronapreve</i> was a neutralising monoclonal antibody introduced into UK COVID-19 guidelines in 2021. It reduces mortality in seronegative patients infected with non-omicron variants. Antibody testing on admission is therefore vital in ensuring patients could be considered for <i>Ronapreve</i> as inpatients.<h4>Local problem</h4>We found that on our COVID-19 ward, 31.4% of patients were not having anti-S tests despite fulfilling the other criteria to be eligible for <i>Ronapreve</i>. This was identified as an important target to improve; by not requesting anti-S tests, we were forgoing the opportunity to use an intervention that could improve outcomes.<h4>Methods</h4>We analysed patient records for patients with COVID-19 admitted to our ward over 4 months to observe if awareness of the need to request anti-S increased through conducting plan-do-study-act (PDSA) cycles.<h4>Interventions</h4>Our first intervention was an multidisciplinary team (MDT) discussion at our departmental audit meeting highlighting our baseline findings and the importance of anti-S requesting. Our second intervention was to hang printed posters in both the doctors' room and the ward as a visual reminder to staff. Our final intervention was trust-wide communications of updated local COVID-19 guidance that included instructions for anti-S requesting on admission.<h4>Results</h4>Our baseline data showed that only 68.6% of patients with symptomatic COVID-19 were having anti-S antibody tests requested. This increased to 95.0% following our three interventions. There was also a reduction in the amount of anti-S requests being 'added on', from 57.1% to 15.8%.<h4>Conclusions</h4>COVID-19 guidelines are constantly evolving and require interventions that can be quickly and easily implemented to improve adherence. Sustained reminders through different approaches allowed a continued increase in requesting. This agrees with research that suggests a mixture of educational sessions and visual reminders of guidelines increase their application in clinical practice.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | COVID-19, Quality improvement, Quality measurement |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Clinical Directorate |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 05 Oct 2022 06:25 |
| Last Modified: | 18 Jan 2023 20:40 |
| DOI: | 10.1136/bmjoq-2022-001886 |
| Open Access URL: | https://bmjopenquality.bmj.com/content/11/3/e00188... |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3165178 |
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