How EPMA is Transforming Antimicrobial Stewardship
- Mar 20
- 2 min read
Antimicrobial resistance (AMR) remains a global health crisis, requiring hospitals and healthcare providers to adopt robust Antimicrobial Stewardship (AMS) programs. While clinical expertise drives these initiatives, EPMA (Electronic Prescribing and Medicines Administration) systems play a crucial role in enabling and enhancing stewardship efforts.
1. Using EPMA for Diagnostic-Based Ordersets (DBOS)
A key challenge in AMS is ensuring prescribing aligns with local resistance patterns and best-practice guidelines. To address this, our EPMA team developed Diagnostic-Based Ordersets (DBOS) for the 17 most common infection types. These allow prescribers to select infection-specific treatment options, with pre-set doses and frequencies, ensuring antimicrobial use is targeted, consistent, and safe.
2. Automating IV Flush Prescriptions to Improve Compliance
It’s a common but often overlooked issue—up to 50% of IV antimicrobials can remain in the giving set without proper flushing. To improve compliance, we automated IV flush prescriptions within EPMA, ensuring every IV antimicrobial order includes an appropriate flush. This small but impactful change has improved patient safety and auditability.
3. Tracking IV Administration Methods (Bolus vs Infusion)
To promote bolus administration over prolonged infusions, we amended nursing task forms within EPMA to capture the method of IV administration. This data helps the AMS team monitor adherence to best practices and drive improvements in antimicrobial delivery.
4. Developing an Antimicrobial Usage Dashboard
Understanding how, when, and where antimicrobials are prescribed is critical for stewardship. We collaborated with Business Intelligence (BI) teams to extract and visualize key antimicrobial usage data from the EPR database. This real-time dashboard allows AMS teams to track prescribing trends and identify areas for improvement.
5. Auditing DBOS Orderset Impact
The effectiveness of AMS initiatives hinges on monitoring adoption and compliance. By integrating data capture fields into antimicrobial prescription orders, EPMA now enables BI teams to track DBOS adoption rates, helping to refine and optimize prescribing workflows.
6. Implementing the Antimicrobial Review Kit (ARK) within EPMA
The Antimicrobial Review Kit (ARK) encourages clinicians to classify antimicrobial prescriptions as Possible, Probable, or Confirmed infections. By adding a new classification field within EPMA, we have provided a structured way to support responsible prescribing, reinforcing the AMS team’s efforts in reducing unnecessary antimicrobial use.
Conclusion: EPMA’s Role Beyond Digital Prescribing
EPMA is more than just a digital prescribing tool, it is a powerful enabler of better medicines management and patient safety. From automating stewardship practices to enhancing auditability and data driven decision making, EPMA is at the heart of modern AMS strategies. These digital enhancements, when aligned with clinical expertise, make a tangible difference in tackling antimicrobial resistance and improving patient care.
What’s next?
As EPMA technology evolves, its potential to support AI-driven prescribing, advanced analytics, and real-time intervention alerts will only continue to grow, further shaping the future of antimicrobial stewardship.
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