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Kia āta kōwhiri Choosing Wisely

The Choosing Wisely campaign seeks to reduce harm from unnecessary and low-value tests and treatment.

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Medicines management

The Health Quality & Safety Commission (the Commission) is partnering with the aged residential care (ARC) sector to develop and implement a quality improvement programme to improve the use of medicines.

Early in 2020, the Commission undertook a rapid literature review around prescribing antibiotics, antipsychotics and fentanyl in ARC. Current evidence from Aotearoa New Zealand suggests that not all use of antibiotics for urinary tract infection (UTI), antipsychotics for behavioural and psychological symptoms of dementia, or fentanyl for chronic pain follows evidence-based guidance. The report, Appropriate medication use in aged residential care: Optimising the use of antibiotics, antipsychotics and fentanyl written by Adapt Research, outlines potential interventions to reduce the use of inappropriate prescribing and problematic polypharmacy. The findings can be used to create targeted approaches to improve the use of these medicines in ARC.

Based on the review findings, the Commission has been working on a quality improvement project to improve the use of antibiotics in the management of UTIs in ARC. Work has included:

  • an online introductory quality improvement course for ARC staff to improve sector capability
  • development and support of a quality improvement project to develop a suite of interventions with project teams across the motu, based on a project by Public Health Ontario
  • publishing a guide to improve the use of antibiotics in the management of UTIs in ARC, including a range of practical tools.

In 2022 and 2023, the Commission will work with a range of providers to implement these tools on a larger scale.

Resources include:

  • Appropriate medication use in aged residential care: Optimising the use of antibiotics, antipsychotics and fentanyl (report by Adapt Research)
  • Guide to improving the use of antibiotics in the management of UTIs in ARC, with supporting documents:
  • UTI decision support tool
  • educational presentation to assist teams with implementation
  • process surveillance spreadsheet
  • implementation checklist
  • staff knowledge and confidence survey
  • prescriber letter.

If you have any queries, please contact us at arc@hqsc.govt.nz.

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Published: 21 Oct 2021 Modified: 13 Oct 2022