The OPEN project: Out of Hours Prescribing: Enhancing CommunicatioN was an observational study on the management of common infections out of hours. The study aimed to:
- understand the organisational, clinical and social context for the management of common infections in out-of-hours urgent care
- design tailored communication training to improve prudent prescribing practice.
This project was run by Dr Rebecca Barnes and Dr Joe Webb who undertook fieldwork alongside clinicians in treatment centres and on home visits.
Key learning points from the study findings included:
- Consciously ask about prior self-care
- When ruling out an antibiotic offer positive then negative comments e.g. "You're doing the right things and there's no sign that antibiotics are needed at this point"
- Advise on natural history time-frames
- Offer written materials that include self-care and safety-netting advice if possible
- Walk through public guidance with patients
- Be clear when prescribing an antibiotic whether it is for immediate or delayed use
- Distinguish a delayed from a standby antibiotic
- Specify when to take delayed antibiotic e.g. "If X then Y"
- Give careful safety netting information
- Use ideas, concerns and expectations when navigating decision making around treatment options.
- Verbalise reassuring clinical signs during physical examination.
The key output from the project was four learning modules which are now on the e-LFH platform Search for: Antimicrobial Stewardship (AMS) out of hours (for all four modules) or individually for:
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- 1. Safety Netting for common infections in out-of-hours primary care
- 2. Delayed antibiotic prescribing for common infections in out-of-hours primary care
- 3. Managing patient expectations in out-of-hours primary care
- 4. Promoting self-care in out-of-hours primary care
Please take a moment to read the informative posters linked below:
