The management of adult patients with meningitis at Arrowe Park Hospital – A complete audit cycle
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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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.065 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.006 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".