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Alam, Ali M, Lester, Rebecca 
ORCID: https://orcid.org/0000-0002-0259-9630, Hoyle, Marie-Claire, Fletcher, Tom and Hine, Paul
(2022)
'Increasing anti-S antibody testing: a quality improvement initiative with evolving COVID-19 guidelines.'. BMJ Open Quality, Vol 11, Issue 3, e001886.
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PMC9471206.pdf - Published Version Available under License Creative Commons Attribution. Download (768kB) | Preview |
Abstract
Background
COVID-19 management guidelines are constantly evolving, making them difficult to implement practically. Ronapreve 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 Ronapreve as inpatients.
Local problem
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 Ronapreve. 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.
Methods
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.
Interventions
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.
Results
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%.
Conclusions
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 |
|---|---|
| Subjects: | QW Microbiology and Immunology > Reference Works. General Immunology > QW 520 Research (General) QW Microbiology and Immunology > Antigens and Antibodies. Toxins and Antitoxins > QW 575 Antibodies WC Communicable Diseases > Virus Diseases > Viral Respiratory Tract Infections. Respirovirus Infections > WC 506 COVID-19 |
| Faculty: Department: | Clinical Sciences & International Health > Clinical Sciences Department |
| Digital Object Identifer (DOI): | https://doi.org/10.1136/bmjoq-2022-001886 |
| SWORD Depositor: | JISC Pubrouter |
| Depositing User: | JISC Pubrouter |
| Date Deposited: | 17 Nov 2022 10:41 |
| Last Modified: | 17 Nov 2022 10:41 |
| URI: | https://archive.lstmed.ac.uk/id/eprint/21321 |
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