Who's counting? How many IV antibiotic administrations are given daily at four Midlands trusts

Abstract Background Up to 80% of patients admitted to hospital receive IV therapy during their stay.1 In the UK, the NHS England Commissioning for Quality and Innovation (CQUIN) audit for quarter 1 of 2023–24 in the Midlands shows that 9.1%–35.0% of patients prescribed IV antibiotics are appropriate for a switch to oral therapy. A recent time and motion study demonstrated that IV medicine administration takes 20 min longer to give than an oral preparation.2 Consequently, an appropriate IV to oral switch releases 20 min of nurse time per dose administered. The unknown parameter is ‘how many antibiotic injections are given daily in hospitals’. Quantifying this parameter would enable Trusts to calculate the workforce capacity that could be realized on implementing an effective IVOS pathway. Methods The number of IV antibiotics administered to inpatients was determined on one day for seven consecutive weeks at four Midlands trusts. In Week 1, data were collected on Sunday, Week 2 on Monday and so on until Week 7 on Saturday. Finally, the ratio of number of IV antibiotics doses per number of occupied beds was determined. Results The range of the number of doses administered per occupied beds was between 0.92 and 1.18; it would be reasonable therefore to use the approximation of the number of antibiotic injections given daily at the four trusts as one injection per occupied bed. Taking a pragmatic approach that 20% of IV doses could be given orally with each change to oral releasing 20 min per administration we are proposing a calculation for the potential workforce released if an effective IVOS pathway is implemented: number of workforce hours released/day=number of trust beds/15. Conclusions Implementation of an effective IVOS pathway has the potential to release a significant number of hours each day to nurses to undertake other tasks.