Experiences and perspectives of implementing antimicrobial stewardship in five French hospitals: a qualitative study

Perozziello, Anne; Routelous, Christelle; Charani, Esmita; Truel, Alice; Birgand, Gabriel; Yazdanpanah, Y.; Lescure, François-Xavier; Lucet, Jean‐Christophe; Burdet, Charles; Kardas, Lidia; Lepeule, R.; Lesprit, Philippe; L’Hériteau, F.; Nguyen, Liem-Binh Luong; Mourvillier, Bruno; Vaillant, L.; Zahar, Jean‐Ralph

doi:10.1016/j.ijantimicag.2018.01.002

Cited by 27 publications

(20 citation statements)

References 24 publications

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“…Like in the case of IT innovation adoption, for example, managers who are aware of the seriousness of AMR and with previous experience of ASPs are more likely to adopt the innovation [20]. Without management support, the adoption, implementation and continuation of ASPs can be affected, as shown in previous studies [21,22].…”

Section: Discussionmentioning

confidence: 91%

Barriers to implementing antimicrobial stewardship programmes in three Saudi hospitals: Evidence from a qualitative study

Alghamdi

Atef-Shebl

Aslanpour

et al. 2019

Journal of Global Antimicrobial Resistance

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Section: Discussionmentioning

confidence: 91%

Barriers to implementing antimicrobial stewardship programmes in three Saudi hospitals: Evidence from a qualitative study

Alghamdi

Atef-Shebl

Aslanpour

et al. 2019

Journal of Global Antimicrobial Resistance

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“…Komitmen yang kuat dari pimpinan RS untuk memenuhi kebutuhan sumber daya penunjang sangat dibutuhkan untuk menjamin keberhasilan inisiasi dan keberlangsungan ASP [36]. Beberapa penelitian terpublikasi menunjukkan bahwa dukungan yang tidak optimal dari pimpinan RS berdampak pada ketidakoptimalan implementasi ASP [18,37]. Dengan disertakannya ASP atau PPRA sebagai program wajib dalam penilaian akreditasi RS di Indonesia per tahun 2017, diharapkan komitmen pimpinan RS terhadap implementasi ASP dapat ditingkatkan [12].…”

Section: Tema 2: Relevansi Implementasi Asp Bagi Rumah Sakitunclassified

“…Tabel 3 memaparkan detail jenis strategi ASP yang dipilih oleh partisipan. Pembuatan pedoman atau clinical pathway merupakan jenis intervensi yang paling banyak (35,8%) disarankan dalam penelitian ini dan sekaligus juga banyak dikehendaki atau diimplementasikan di rumah sakit di negara lain [37][38][39]. Banyaknya pilihan terhadap pedoman terapi atau clinical pathway tidak dapat dilepaskan dari peran dua dokumen tersebut dalam membantu dokter untuk memilih jenis, dosis, dan durasi terapi antibiotik terbaik bagi pasien [40,41].…”

Section: Strategi Asp Yang Disarankanunclassified

Persepsi Dokter tentang Strategi Antimicrobial Stewardship Program di Sebuah Rumah Sakit Umum di Surabaya

2020

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Antimicrobial Stewardship Program (ASP) dikembangkan untuk mengoptimalkan penggunaan antibiotik melalui implementasi kebijakan, strategi maupun pedoman. Penelitian ini bertujuan untuk mengkaji persepsi dokter terhadap ASP dan mengeksplorasi pilihan beserta pertimbangan pemilihan suatu jenis strategi ASP. Pendekatan kualitatif melalui wawancara dengan dokter yang aktif bekerja di sebuah rumah sakit umum di kota Surabaya dilakukan dengan bantuan panduan wawancara semi terstruktrur untuk mengeksplorasi: i) sikap terhadap implementasi ASP, dan ii) strategi ASP yang disarankan. Hasil wawancara diolah secara thematic analysis. Sebanyak 27 dokter bersedia terlibat. Secara umum, partisipan memiliki sikap yang baik terhadap implementasi ASP. Terdapat tiga tema terkait implementasi ASP, yaitu: 1) persetujuan implementasi sebagai konsekuensi dari bagian komunitas profesi di rumah sakit (RS); 2) relevansi implementasi bagi perbaikan kualitas RS, dan 3) tuntutan pemenuhan sumber daya sebelum diimplementasikan. Pembuatan pedoman terapi atau clinical pathway merupakan strategi yang paling banyak dipilih oleh partisipan. Pertimbangan dalam memilih suatu strategi adalah: 1) kesepakatan oleh komunitas RS; 2) practicability dan feasibility; dan 3) penggunaan bukti penelitian sebagai dasar penyusunan strategi. Penelitian ini memberikan gambaran mengenai persepsi dokter terkait dengan implementasi ASP. Diharapkan hasil penelitian ini dapat dijadikan sebagai salah satu acuan dalam merancang strategi ASP yang tepat dalam konteks RS di Indonesia.

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“…Recent qualitative work investigated factors that drive adherence to infectious diseases' advice, highlighting the role of local culture and practices, physicians' personal experience, involvement of hospital authorities, physicians' interest, and willingness to conform to guidelines. 80,81 Funding limitations and variability in resources dedicated to ASP also differ between institutions, hampering successful universal implementation.…”

Section: Antimicrobial Stewardship Programs and Rapid Diagnostic Toolsmentioning

confidence: 99%

Controlling the Diffusion of Multidrug-Resistant Organisms in Intensive Care Units

Kernéis

Lucet

2019

Semin Respir Crit Care Med

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The prevalence of multidrug-resistant organisms (MDROs) in intensive care units (ICUs) is increasing worldwide, with very large variations across countries, microorganisms, and settings. Emerging MDR gram-negative bacteria and fungi raise particular concerns that require improved prevention and control strategies. Vertical approaches are mainly based on screening and contact precautions and/or decolonization of MDRO carriers. On the other hand, horizontal strategies are not pathogen-specific and include standard precautions (i.e., hand hygiene), universal decolonization, antimicrobial stewardship, and environmental cleaning. The impacts of the different strategies vary between MDROs and compliance with control measures, and are intermixed in most infection control programs. Based on historical data, hand hygiene remains the cornerstone to prevent transmission of MDROs in ICUs. In the context of high hand hygiene compliance, screening and contact precautions for carriers seem to have a limited additional effect, particularly for MDR gram-negative bacteria. Studies on skin decolonization with chlorhexidine bathing show conflicting results, impairing its widespread adoption. Selective oral and digestive decontaminations have shown positive impact on clinical outcomes in ICUs with low levels of antibiotic resistance, but raised ecological concerns in high-prevalence settings. Antibiotic stewardship programs have been associated with reductions in antimicrobial use, duration of stay, and costs with no negative impact on mortality and should be widely promoted in ICUs. Whatever the strategy, compliance with the recommended measures is of crucial importance and implementation should rely on behavioral approach and change in the institutional and safety culture.

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Experiences and perspectives of implementing antimicrobial stewardship in five French hospitals: a qualitative study

Cited by 27 publications

References 24 publications

Barriers to implementing antimicrobial stewardship programmes in three Saudi hospitals: Evidence from a qualitative study

Barriers to implementing antimicrobial stewardship programmes in three Saudi hospitals: Evidence from a qualitative study

Persepsi Dokter tentang Strategi Antimicrobial Stewardship Program di Sebuah Rumah Sakit Umum di Surabaya

Controlling the Diffusion of Multidrug-Resistant Organisms in Intensive Care Units

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