Before you e-mail/phone
- In most situations, junior staff should discuss the problem with senior members of their own team, and consult the Antimicrobial Handbook and Microbiology Test Directory before seeking Consultant microbiology advice.
- Know your patient
- Name, CHI number and current location
- Date of admission and working diagnosis
- Brief relevant clinical history, including current clinical progress and observations
- Results of relevant diagnostic results e.g. WCC, CRP, eGFR, imaging
- The dose and duration of current and previous antibiotics, including pre-admission
- Include any previous microbiology history e.g. MRSA/ESBL/C. difficile, recent culture results
- Full travel history, if relevant.
- If allergic to any antibiotic, obtain a clear picture of the nature of the allergic reaction
Remember, the Microbiologist is entirely reliant on the detail and accuracy of the information provided by the referrer - they have no patient notes, observation charts, blood results or radiology reports. Without this it is almost impossible to give meaningful, high quality and safe advice.
If a patient is unexpectedly deteriorating and/or there is no clear diagnosis, this MUST be discussed with a more senior clinician before asking for microbiology advice
E-mail referrals should include:
- Referrer name, phone number / extension to receive call back
- Patient name, CHI, location
- Name of responsible clinical consultant - must be copied into the e-mail
- Patient summary with relevant clinical details
- See "know your patient" above
- If required, a Microbiology referral proforma is available: HERE
- Description of reason for advice request e.g.
- investigation of infection
- antimicrobial choice - empirical / definitive / oral stepdown
- antimicrobial duration, dosing, therapeutic drug monitoring
- further susceptibilities
E-mail queries and responses must be printed and filed within the patient notes.
NHS Dumfries & Galloway Antimicrobial Handbook
