Administration of a survey to evaluate the attitudes of house staff physicians towards antimicrobial resistance and the antimicrobial stewardship programme at a community teaching hospital

Venugopalan, Veena; Trustman, Nathan; Manning, Nyla; Hashem, Nehal Gamal; Berkowitz, Leonard; Hidayat, Levita

doi:10.1016/j.jgar.2016.01.004

Cited by 25 publications

(22 citation statements)

References 17 publications

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“…As described in similar studies, respondents generally recognized antibiotic misuse and antimicrobial stewardship as important issues, 14,16,17 and most had positive attitudes toward ASPs, both in their ability to increase appropriateness of antimicrobial prescribing and to improve patient care. 16,19 However, some respondents, particularly residents, had negative attitudes toward ASPs because they thought ASPs delayed care and restricted autonomy. The survey also identified several specific and actionable deficiencies related to knowledge, prescribing practices, and awareness of available resources that can be addressed to improve antimicrobial prescribing at the study hospitals.…”

Section: Discussionmentioning

confidence: 73%

“…Many of these deficiencies have also been identified in other studies. [12][13][14][16][17][18] figure 1. Antimicrobial prescribing confidence versus knowledge of antimicrobial prescriber survey respondents.…”

Section: Discussionmentioning

confidence: 99%

“…As in other studies, respondents indicated that PPRF would be a useful resource. 16,19 For education, most respondents preferred computer-based training and lectures.…”

Section: Discussionmentioning

confidence: 99%

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Knowledge, Attitudes, and Practices Regarding Antimicrobial Use and Stewardship Among Prescribers at Acute-Care Hospitals

Salsgiver

Bernstein

Simon

et al. 2018

Infect. Control Hosp. Epidemiol.

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OBJECTIVE To assess antimicrobial prescriber knowledge, attitudes, and practices (KAP) regarding antimicrobial stewardship (AS) and associated barriers to optimal prescribing. DESIGN Cross-sectional survey. SETTING Online survey. PARTICIPANTS A convenience sample of 2,900 US antimicrobial prescribers at 5 acute-care hospitals within a hospital network. INTERVENTION The following characteristics were assessed with an anonymous, online survey in February 2015: attitudes and practices related to antimicrobial resistance, AS programs, and institutional AS resources; antimicrobial prescribing and AS knowledge; and practices and confidence related to antimicrobial prescribing. RESULTS In total, 402 respondents completed the survey. Knowledge gaps were identified through case-based questions. Some respondents sometimes selected overly broad therapy for the susceptibilities given (29%) and some "usually" or "always" preferred using the most broad-spectrum empiric antimicrobials possible (32%). Nearly all (99%) reported reviewing antimicrobial appropriateness at 48-72 hours, but only 55% reported "always" doing so. Furthermore, 45% of respondents felt that they had not received adequate training regarding antimicrobial prescribing. Some respondents lacked confidence selecting empiric therapy using antibiograms (30%), interpreting susceptibility results (24%), de-escalating therapy (18%), and determining duration of therapy (31%). Postprescription review and feedback (PPRF) was the most commonly cited AS intervention (79%) with potential to improve patient care. CONCLUSIONS Barriers to appropriate antimicrobial selection and de-escalation of antimicrobial therapy were identified among front-line prescribers in acute-care hospitals. Prescribers desired more AS-related education and identified PPRF as the most helpful AS intervention to improve patient care. Educational interventions should be preceded by and tailored to local assessment of educational needs. Infect Control Hosp Epidemiol 2018;39:316-322.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

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Knowledge, Attitudes, and Practices Regarding Antimicrobial Use and Stewardship Among Prescribers at Acute-Care Hospitals

Salsgiver

Bernstein

Simon

et al. 2018

Infect. Control Hosp. Epidemiol.

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“…Healthcare professionals (HCPs) working in hospitals should have adequate knowledge and awareness of AMR, its triggering factors, and strategies required to cope with AMR (Labi et al, 2018;Nicholson et al, 2018;Hayat et al, 2019a;Kalungia et al, 2019). Different professionals will have different views which could affect the functioning of hospital ASPs (Venugopalan et al, 2016;Salsgiver et al, 2018). Furthermore, the success of implementing ASPs in hospitals is highly dependent on the joint efforts of HCPs, including ID physicians, pharmacists, and nurses.…”

Section: Introductionmentioning

confidence: 99%

Perspective of Key Healthcare Professionals on Antimicrobial Resistance and Stewardship Programs: A Multicenter Cross-Sectional Study From Pakistan

et al. 2020

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Background: Antimicrobial resistance (AMR) is an increasing global threat, and hospitalbased antimicrobial stewardship programs (ASPs) are one of the effective approaches to tackle AMR globally. This study was intended to determine the attitude of key healthcare professionals (HCPs), including physicians, nurses, and hospital pharmacists, towards AMR and hospital ASPs. Methods: A cross-sectional study design was used to collect data from HCPs employed in public teaching hospitals of Punjab, Pakistan, from January 2019 to March 2019. A cluster-stratified sampling method was applied. Descriptive statistics, Mann Whitney and Kruskal Wallis tests were used for analysis. Results: A response rate of 81.3% (881/1083) for the surveys was obtained. The majority of the physicians (247/410, 60.2%) perceived AMR to be a serious problem in Pakistani hospitals (p < 0.001). Most of the HCPs considered improving antimicrobial prescribing (580/881, 65.8%; p < 0.001) accompanied by the introduction of prospective audit with feedback (301/ 881, 75.8%; p < 0.001), formulary restriction (227/881, 57.2%; p = 0.004) and regular educational activities (300/881, 75.6%; p = 0.015) as effective ASP methods to implement hospital ASPs in Pakistan. A significant association was found between median AMR and ASP scores with age, years of experience, and types of HCPs (p < 0.05). Conclusions: The attitude of most of the HCPs was observed to be positive towards hospital-based ASPs regardless of their poor awareness about ASPs. The important strategies, including prospective audit with feedback and regular educational sessions proposed by HCPs, will support the initiation and development of local ASPs for Pakistani hospitals.

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“…Several KAP surveys on antimicrobial resistance have been conducted among physicians in community settings [ 8 – 13 ]. Fewer studies have been performed among physicians in tertiary care settings, and these are mostly from Europe [ 11 , 14 , 15 ] and the Americas [ 10 , 16 ]. In Africa, KAP studies on antibiotic resistance are rare [ 17 – 20 ].…”

Section: Introductionmentioning

confidence: 99%

Physicians’ knowledge, attitudes, and perceptions concerning antibiotic resistance: a survey in a Ghanaian tertiary care hospital

Labi

Obeng‐Nkrumah

Bjerrum

et al. 2018

BMC Health Serv Res

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BackgroundUnderstanding the knowledge, attitudes and practices of physicians towards antibiotic resistance is key to developing interventions aimed at behavior change. The survey aimed to investigate physicians’ knowledge and attitudes towards antibiotic resistance in a tertiary-care hospital setting in Ghana.MethodsWe conducted a cross-sectional respondent-driven survey using a 40-item, anonymous, voluntary, traditional paper-and-pencil self-administered questionnaire among 159 physicians at Korle-Bu Teaching Hospital. Single and multi-factor analysis were conducted to assess the study objectives.ResultsThe survey was completed by 159 of 200 physicians (response rate of 79.5%). Of physicians, 30.1% (47/156) perceived antibiotic resistance as very important global problem, 18.5% (29/157) perceived it as very important national problem and only 8.9% (14/157) thought it as a very important problem in their hospital. Methicillin resistant Staphylococcus aureus was the most known about antibiotic resistant bacteria of public health importance followed by extended-spectrum beta-lactamase-producing Enterobacteriaceae, carbapenem resistant Enterobacteriaceae (CRE) and vancomycin resistant enterococci (VRE). In multiple logistic regression analysis, senior physicians were nearly 3 times more likely to know about CRE than junior physicians. The odds of knowing about VRE increased over 4.5 times from being a junior to becoming senior physician. Among junior physicians, age had no associated effect on their knowledge of VRE or CRE.ConclusionsPhysicians in this survey showed variable knowledge and perceptions on antibiotic resistance. Introducing educational programs on antibiotic resistance would be a useful intervention and should focus on junior physicians.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-2899-y) contains supplementary material, which is available to authorized users.

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Administration of a survey to evaluate the attitudes of house staff physicians towards antimicrobial resistance and the antimicrobial stewardship programme at a community teaching hospital

Cited by 25 publications

References 17 publications

Knowledge, Attitudes, and Practices Regarding Antimicrobial Use and Stewardship Among Prescribers at Acute-Care Hospitals

Knowledge, Attitudes, and Practices Regarding Antimicrobial Use and Stewardship Among Prescribers at Acute-Care Hospitals

Perspective of Key Healthcare Professionals on Antimicrobial Resistance and Stewardship Programs: A Multicenter Cross-Sectional Study From Pakistan

Physicians’ knowledge, attitudes, and perceptions concerning antibiotic resistance: a survey in a Ghanaian tertiary care hospital

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