The management of adult patients with meningitis at Arrowe Park Hospital – A complete audit cycle
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Background: Anecdotal experience suggested there were areas for improvement in meningitis management. To address this, we conducted a complete audit cycle of the management of meningitis in adult patients at Arrowe Park Hospital. Method: We utilised the abbreviated audit tool from the McGill et al 2016 meningitis guidelines. Time period: 1/1/2017 to 31/12/2017. Cases audited: 20 A series of interventions were made. Time period for second cycle: 1/2/2019 to 31/5/2019. Cases audited: 6 Results: Audit standards were met for 1 out of 14 criteria for the first cycle and 2 out of 14 criteria for the second cycle. Of note, there was reasonable compliance with empiric choice of antibiotic (80% à 83%), definitive choice of antimicrobials (95% à83%) and duration of antimicrobials (84% à 100%). Improvements in investigations were seen in the second cycle: 1.Pneumococcal and Meningococcal EDTA PCR was sent (15% à 67%) 2.CSF glucose with concurrent plasma glucose sent (6.3% à 67%) 3.CSF for pneumococci and meningococci sent in all cases of suspected bacterial meningitis (22% à 67%) The re-audit identified no improvement in the following areas: 1.Blood cultures taken within 1 h of arrival at hospital (30% à 33%) 2.LP performed within 1 h of arrival at hospital provided that it is safe to do so (0% à 0%) 3.Antibiotics started within 1 hr of arrival in hospital (35% à 33%) In both audit cycles, 0% of patients were made aware of voluntary sector support. Conclusion: Whilst improvements were achieved, there remains considerable scope for further improvement.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it