Barriers to uptake of antimicrobial advice in a UK hospital: a qualitative study

Broom, Jennifer; Broom, Alex; Plage, Stefanie; Adams, Kate; Post, Jeffrey J.

doi:10.1016/j.jhin.2016.03.011

Cited by 63 publications

(76 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Restrictive stewardship interventions can be effective, but overall the results have been variable [17]. Restrictive strategies have limitations because they rarely change social norms or 'prescribing etiquette' [18] and can be damaging to relationships between healthcare staff [19,20]. If imposed by an authority (e.g.…”

Section: Theory-based Interventions For Managing Common-pool Resourcesmentioning

confidence: 99%

“…If imposed by an authority (e.g. hospital management), restrictive interventions can also undermine a sense of collective ownership of decision makers [19], and result in staff working to resist or circumvent the restrictions [21].…”

Section: Theory-based Interventions For Managing Common-pool Resourcesmentioning

confidence: 99%

“…Furthermore, future needs for antibiotics to fight infections are stochastic and cannot be quantified or predicted with certainty [33]. The loss of antibiotic efficacy is commonly perceived to be a vague and distant threat [19,20,34].…”

Section: Lack Of Visibility and Imminencementioning

confidence: 99%

See 2 more Smart Citations

Optimizing antibiotic prescribing: collective approaches to managing a common-pool resource

Tarrant

Colman

Chattoe-Brown

et al. 2019

Clinical Microbiology and Infection

View full text Add to dashboard Cite

Background: Antimicrobial resistance (AMR) is one of the greatest threats in 21st century medicine. AMR has been characterized as a social dilemma. A familiar version describes the situation in which a collective resource (in this case, antibiotic efficacy) is exhausted due to over-exploitation. The dilemma arises because individuals are motivated to maximize individual payoffs, although the collective outcome is worse if all act in this way. Objectives: We aim to outline the implications for antimicrobial stewardship of characterizing antibiotic overuse as a social dilemma. Sources: We conducted a narrative review of the literature on interventions to promote the conservation of resources in social dilemmas. Content: The social dilemma of antibiotic over-use is complicated by the lack of visibility and imminence of AMR, a loose coupling between individual actions and the outcome of AMR, and the agency relationships inherent in the prescriber role. We identify seven strategies for shifting prescriber behaviour and promoting a focus on the collectively desirable outcome of conservation of antibiotic efficacy: (1) establish clearly defined boundaries and access rights; (2) raise the visibility and imminence of the problem; (3) enable collective choice arrangements; (4) conduct behaviour-based monitoring; (5) use social and reputational incentives and sanctions; (6) address misalignment of goals and incentives; and (7) provide conflict resolution mechanisms. Implications: We conclude that this theoretic analysis of antibiotic stewardship could make the problem of optimizing antibiotic prescribing more tractable, providing a theory base for intervention development.

show abstract

Section: Theory-based Interventions For Managing Common-pool Resourcesmentioning

confidence: 99%

Section: Theory-based Interventions For Managing Common-pool Resourcesmentioning

confidence: 99%

See 1 more Smart Citation

Optimizing antibiotic prescribing: collective approaches to managing a common-pool resource

Tarrant

Colman

Chattoe-Brown

et al. 2019

Clinical Microbiology and Infection

View full text Add to dashboard Cite

show abstract

“…22 Previous data from international and American settings suggest that resource limitations, lack of executive leadership support, and cultural barriers regarding antimicrobial prescribing are major challenges for successful ASP implementation. [23][24][25][26] However, it is not known how leading ASPs are evolving strategies to overcome these barriers in the face of technological innovation and ongoing regulatory and accreditation requirements. We used qualitative methods to identify and describe characteristics of leading ASPs and novel strategies for stewardship.…”

mentioning

confidence: 99%

The Expanding Role of Antimicrobial Stewardship Programs in Hospitals in the United States: Lessons Learned from a Multisite Qualitative Study

Kapadia¹,

Abramson²,

Carter³

et al. 2018

The Joint Commission Journal on Quality and Patient Safety

View full text Add to dashboard Cite

“…It is one of the important barriers in APSs and includes conflict regarding the responsibilities for different health care professionals, opposition from prescribers, the communication with antagonizing colleagues, and heterogeneity in the prescribing practices, refuse to accept policies, guidelines about use of antimicrobials, and clinical misconceptions. In addition to that, the limited contact between the health care professionals and the relations between them may compromise on the success of ASPs (4,5,9,14,17,18,19,20,21,23,24,27,28,29,30).…”

Section: Inter-professional and Inter-specialty Conflictmentioning

confidence: 99%

The Barriers in the implementation of Antimicrobial Stewardship Programs: A systematic Review

Ahmed

Khan

Hassali

et al. 2019

Preprint

View full text Add to dashboard Cite

Background The resistance to Antimicrobial is considered as one of the most important risks that affect public health and healthcare. Antimicrobial stewardship programs comprise a series of interventions that help to stop the inappropriate use of antimicrobials.Methods The published literature on the barriers of implementing stewardship programs is limited. We searched for the relevant articles from 2007 till the end of 2017 using the keyword “Antimicrobial Stewardship Programs" in PubMed database.Results There are many barriers in the implementation of antimicrobial stewardship programs. To improve the rational use of antibiotics it is important to overcome these barriers.Conclusion According to the included studies into current review or manuscript, there are 9 major barriers for ASPs. Lack of training and knowledge, inter-professional and inter-specialty conflict, and lack of resources are the most common barriers.

show abstract

Barriers to uptake of antimicrobial advice in a UK hospital: a qualitative study

Cited by 63 publications

References 13 publications

Optimizing antibiotic prescribing: collective approaches to managing a common-pool resource

Optimizing antibiotic prescribing: collective approaches to managing a common-pool resource

The Expanding Role of Antimicrobial Stewardship Programs in Hospitals in the United States: Lessons Learned from a Multisite Qualitative Study

The Barriers in the implementation of Antimicrobial Stewardship Programs: A systematic Review

Contact Info

Product

Resources

About