25 August 2020
Doctors can now calculate the correct dose for a common antibiotic at the click of a button- thanks to the clinical and digital teams at the Royal Free London
The EPR team and microbiology department worked alongside the IT company Cerner to design and implement a dose calculator which in embedded into the electronic patient record (EPR). The calculator automatically calculates the right dose for patients receiving gentamicin – an antibiotic used to treat urinary tract infections and sepsis.
Getting the gentamicin dose correct is notoriously tricky and requires a combination of several mathematical equations. Prescribers are sometimes put off from prescribing gentamicin due to the risks and complications associated with gentamicin toxicity, including kidney damage and hearing loss.
Since it was introduced, the new calculator, which is used as part of the EPR at Barnet and Chase Farm hospitals, has demonstrated a 100% success rate. This means doctors can be confident their patients are receiving a safe and clinically effective dose of gentamicin.
The calculator has been nominated for a Health Service Journal Patient Safety Award – the results will be presented to a panel of judges before a winner is announced later in the year.
Marisa Lanzman, Senior Pharmacist for Microbiology and ITU said: “We’re delighted to be nominated – we worked really hard to get the calculator right. This is a valuable tool as calculating the dose of gentamicin is challenging due to the need for dose individualisation – and there is such a narrow window for getting it right. If you don’t give patients enough, it has no effect, and if you give them too much, it can be damaging.
“And this is an important antibiotic because there is low resistance to it among bugs.”
Hannah Heales, Lead Clinical Informatics Pharmacist added: “The calculator works by using a range of data such as the patient’s height, weight and renal function. It then compares the results to the patient’s ideal body weight to determine an appropriate dose based on either the actual or corrected weight in line with Trust guidance. This is all done automatically within the EPR taking some of the pressure off the prescribers.”