NMH

NMH | 2024 186 Health and Social Care Professionals the introduction of a new monoclonal antibody called Nirsevimab which was offered to all infants born during the RSV season between 1st September 2024 to 28th February 2025. This programme has drastically reduced hospitalisations due to RSV in infants aged less than 6 months throughout Ireland. Upon request from the Department of Health to facilitate advanced data analysis of determinants of Nirsevimab uptake, the HSE allocated NMH with a temporary Informatics Pharmacist post in order to analyse data from MN-CMS as part of the wider programme evaluation report. This was a major achievement for the Department, who since 2021 had been seeking external funding for such a post to cover cross-site informatics duties as part of the National MN-CMS Medications Workstream. Another major achievement and challenge in 2024 was the introduction of an Automated Dispensing Cabinet (ADC) in Theatre. While initial teething issues were experienced during the changeover, the ADC has enhanced safety and security of medication storage, while greatly improving pharmacy and midwifery/nursing workflow. Introduction of this ADC and its associated workflow was the first step in the upgrade to automated dispensing processes at both pharmacy and ward level for the co-location of The NMH at Elm Park. The exceptional contribution and dedication to patient care that the NMH Pharmacy Team have displayed over the years was recognized in September when our team were nominated for Hospital Pharmacy Team of the Year at the 2024 Hospital Professional Honours in the Dublin Royal Convention Centre at the Radisson Blu Royal Hotel and again in November at the 2024 Pharmacy Excellence Awards in the Mansion House where NMH Pharmacy won Bronze Medal in the same category. In line with continuing implementation of the new hospital pharmacist career structure, the former Chief 2 Pharmacist was promoted to the role of Deputy Pharmacist Executive Manager (DPEM). Applications from Senior Pharmacists to be re-graded as Advanced Specialist Pharmacists (ASPs) were submitted to the HSE and were still under review at the end of the year. For the 4th year running the Department provided an eight-month training placement for a 5th year pharmacy intern. The Department welcomed back our first pharmacy intern from 2021, who covered a maternity leave post for the Antimicrobial Pharmacist, while a new Pharmaceutical Technician started in November, covering another maternity leave post. Drugs and Therapeutics / Medication Safety Committees Medication Safety The Medication Safety Programme completed a review of the previous 5-year (2019-2023) medication safety strategy and launched the new 5-year (2024- 2028) strategy. Twelve medication safety or medication- related audits were conducted in 2024: • Pyrexia in labour administration audit • Sepsis audit (part of Sepsis Committee work) • National Point Prevalence Survey (PPS) of Antibiotic Prescribing • Surgical antibiotic prophylaxis prescribing audit • Carbapenem prescribing review • Group B Streptococcus Management in Penicillin-allergic Pregnant Women • Re-audit of Administration of Anti- Seizure Medications by Clinicians • Midwife Prescribers Audit • VTE assessment documentation and compliance audit using the MEG app VTE audit tool • IV Ferinject administration for severe anaemia following post-partum haemorrhage • To assess completion of the checklist for Neonatal Crash Trolleys • Adult Emergency Trolley Audit Medication safety training was delivered using a combination of learning formats such as HSELand courses, MN-CMS classroom training, NCHD induction training and HR coordinated classroom- based mandatory training, Medication policies, procedures, protocols, guidelines: no new ones were approved and 22 were updated. Antimicrobial Stewardship The Health Protection Surveillance Centre (HPSC) data collection of antimicrobial consumption was suspended in 2024 due to software issues, data validity concerns and limited resources. The decision on how to proceed will be commenced in 2025. As such, the 2024 data is currently unavailable and this report will focus on consumption data results for 2023, which were not reported in the 2024 report. Overall, our consumption for 2023 was 35.14DDD/100BDU which was up from a figure of 33.63DDD/100BDU in 2022 (Figure 1). These results show a rise of 4% in our overall antibiotic consumption in 2023 compared to the previous year, however consumption is still in line with pre-pandemic usage. (Figures from HSE- HPSC report 2023 full year – published October 2024). (DDD: Defined Daily Dose, BDU: Bed Days Used) • The National Point Prevalence Survey (PPS) was conducted in October 2024. The overall prevalence of antimicrobial use for patients on day of survey for 2024 was 21% • Data review examining prescribing of meropenem in 2024 identified that a total of 27 patients were prescribed meropenem (9 adults and 18 neonates). All prescriptions for carbapenems were approved by microbiology or in line with antimicrobial guidelines. • Five audits or prescribing reviews were conducted to assess adherence to AMS guidelines (Pyrexia in labour audit, Surgical antibiotic prophylaxis prescribing audit, National PPS, Carbapenem prescribing, Sepsis audit).

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