MedTech NHS Antimicrobial Stewardship Platform — UK Acute Trust

Antibiotic Prescribing Data Pipeline: HL7 v2 ORM/ORU integration from pharmacy dispensing system (JAC/Ascribe): antibiotic prescription creation, dispensing, and administration events. FHIR R4 MedicationRequest: each antibiotic prescription mapped to FHIR R4 MedicationRequest with dm+d drug code, dose, route, indication, prescriber, and patient. Duration monitoring: prescription start date + prescribed course length → automated stop date alert. IV-to-oral switch: flag prescriptions where oral equivalent is available and patient criteria met. NICE NG15 Compliance Dashboard: NICE NG15 key metrics: 72-hour antibiotic review (all antibiotic prescriptions reviewed by pharmacist or prescriber within 72 hours), IV-to-oral switch rate (target: >75% of eligible prescriptions switched), surgical prophylaxis compliance (correct antibiotic, dose, and duration per Trust formulary), and restricted antibiotic authorisation rate (all restricted antibiotics reviewed by consultant microbiologist). Dashboard: real-time RAG status per metric, trend over time, ward-level drill-down. DCB0129 Antimicrobial Safety Case: Highest safety hazard: wrong dose alert fatigue causing prescribers to dismiss genuine dose errors. Mitigated by: dose range validation per drug, weight-based dosing alerts with patient weight integration, and renal function dose adjustment alerts (eGFR-based). CSO: consultant microbiologist. Hazard Log includes: drug allergy alert bypass risk (mitigated by integration with allergy system — hard stop for documented penicillin allergy). UKHSA Mandatory Surveillance Reporting: UKHSA Start Smart Then Focus (SSTF): monthly antimicrobial consumption data submission (DDD/1,000 patient days per antibiotic class). Electronic Prescribing and Medicines Administration (EPMA) data extract: antibiotic consumption aggregated by BNF class, ward, patient group. UKHSA TARGET toolkit alignment: prescribing quality indicators automatically calculated from prescribing data.