Pharmacist-driven antimicrobial stewardship in intensive care units in East China: A multicenter prospective cohort study

Li, Zhongwang; Cheng, Baoli; Zhang, Kai; Xie, Gary; Wang, Yan; Hou, Jinchao; Chu, Lin; Zhao, Jialian; Xu, Zhifeng; Lu, Zhongqiu; Sun, Huaqin; Zhang, Jian; Wang, Zhiyi; Wu, Haiya; Fang, Xiangming

doi:10.1016/j.ajic.2017.02.021

Cited by 49 publications

(49 citation statements)

References 20 publications

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“…Data terkait asal negara tempat dilakukannya penelitian ASP berdasarkan income status dapat dilihat pada Tabel 1. Sebagian besar penelitian (n=21) dilakukan tidak pada bangsal perawatan khusus dan tujuh penelitian terkait implementasi ASP pada bangsal perawatan khusus, dengan rincian: empat dilakukan di ruang perawatan intensif (ICU), 29,30,54,55 satu penelitian di bangsal hematologi-onkologi 41 dan dua penelitian di bangsal rawat inap anak 45,50 . Dari total 28 artikel penelitian, hanya terdapat satu penelitian yang secara khusus melihat implementasi dari ASP pada penggunaan obat golongan antifungal.…”

Section: Hasilunclassified

“…Formulary restriction and pre-auhorization digunakan sebagai strategi utama dalam tiga artikel; 29,30,32 sedangkan prospective audit with intervention and feedback yang dikombinasikan dengan pemberian edukasi terkait peresepan antibiotik diimplementasikan pada dua penelitian. 31,55 Implementasi di negara high-income economies Artikel terkait implementasi ASP terbanyak dijumpai pada negara high-income economies (n=22). Sebagian besar penelitian tersebut, yakni sebanyak 18 artikel (81,82%), dilakukan pada setting pusat layanan kesehatan tersier atau institusi kesehatan yang juga berafiliasi pada institusi pendidikan tinggi (university affiliated hospitals).…”

Section: Artikel Dianalisis Lebih Lanjutunclassified

“…NA India (n=1) 28 Cina (n=3) 29,30,55 Thailand (n=2) 31,32 Taiwan (n=7) [33][34][35][36][37][38][39] Singapura (n=6) [40][41][42][43][44][45] Jepang (n=5) [46][47][48][49][50] Hong Kong (n=2) 52,53 Korea (n=1) 54 Saudi Arabia (n=1) 51 Keterangan: NA=not-available Pada kajian sistematis ini, jenis intervensi prospective audit with intervention and feedback diimplementasikan pada 20 dari total 28 artikel terkait ASP di kawasan Asia. Terdapat beberapa kemungkinan penyebab implementasi formulary restriction and preauhorization tidak sebanyak prospective audit with intervention and feedback.…”

Section: Upper-middle-income Economies (N) High-income Economies (N)unclassified

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Implementasi Antimicrobial Stewardship Program di Kawasan Asia: Sebuah Kajian Sistematis

Setiawan

Wibowo

Setiadi

et al. 2019

ijcp

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AbstrakAntimicrobial Stewardship Program (ASP) merupakan salah satu program yang direkomendasikan untuk meningkatkan ketepatan penggunaan antibiotik, khususnya pada setting rumah sakit. Keberhasilan implementasi program tersebut ditentukan oleh banyak faktor, antara lain komunikasi antartenaga kesehatan dan ketersediaan sumber daya manusia maupun sarana-prasarana. Sampai saat ini, bukti penelitian terkait implementasi ASP di Asia, khususnya di negara low-dan lower-middle-income economies, masih terbatas. Tujuan kajian sistematik ini adalah mengidentifikasi jenis strategi ASP yang diimplementasikan di berbagai negara Asia dengan berbagai income status, dan memberikan gambaran dampak dari implementasi ASP terhadap luaran klinis, mikrobiologis, dan finansial. Proses penelusuran pustaka dilakukan dengan menggunakan basis data PUBMED dan kata kunci "antimicrobial stewardship" dan "Asia" yang dikombinasikan dengan Boolean operator yaitu "AND". Total terdapat 28 penelitian dari sembilan negara diikutsertakan dalam kajian akhir. Belum ditemukan bukti penelitian terpublikasi terkait ASP di Indonesia. Hanya terdapat satu penelitian berasal dari negara lower-middle-income economies dan penelitian tersebut dilakukan pada institusi kesehatan tersier. Sebagian besar penelitian, yakni 22, berasal dari negara high-middle-income economies, dan 18 dari antaranya dilakukan di rumah sakit tersier atau rumah sakit yang berafiliasi pada institusi pendidikan tinggi. Jenis intervensi ASP yang paling banyak diimplementasikan adalah audit peresepan antibiotik secara prospektif dan disertai dengan pemberian umpan balik, dan penerapannya terbukti dapat menghasilkan luaran yang positif baik secara klinis, mikrobiologis, maupun finansial. Dengan mempertimbangkan dampak positif tersebut, sangat diharapkan agar ASP dapat diimplementasikan pada institusi kesehatan di Indonesia dengan memperhatikan ketersediaan sumber daya dan konteks budaya lokal. AbstractAntimicrobial Stewardship Program (ASP) is one of the recommended programs to optimize the prudent use of antimicrobials, particularly in the hospital settings. The successful ASP implementation is determined by numerous factors, including communication among healthcare workers, and the availability of human resources and facilities. There is limited evidence available regarding the ASP implementation in Asia, particularly in the low-and lower-middle income countries. This systematic review aimed to identify the type of ASP interventions implemented in Asian countries according to the income status and to describe the impact of ASP implementation on the clinical, microbiological, and financial outcomes. The search strategy was undertaken using PUBMED, and the search terms were "antimicrobial stewardship" and "Asia" which were combined with the use of a Boolean operator "AND". In total, 28 articles from nine countries were included in the final review. No article from Indonesia could be found in this systematic review. There was only an article from a lower-middle income country that was conduct...

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Section: Hasilunclassified

Section: Artikel Dianalisis Lebih Lanjutunclassified

Section: Upper-middle-income Economies (N) High-income Economies (N)unclassified

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Implementasi Antimicrobial Stewardship Program di Kawasan Asia: Sebuah Kajian Sistematis

Setiawan

Wibowo

Setiadi

et al. 2019

ijcp

View full text Add to dashboard Cite

show abstract

“…(Table 5). ln STAFF refers to ln PHY in model(5) and model (6), ln NUR in model(7) and model (8), ln PHA in model(9) and model (10) , ln MCB in model (11) and model (12).…”

Section: Correlation Analyses Between the Variablesmentioning

confidence: 99%

“…aureus and coagulase-negative staphylococci rate, by using the provincial panel data in China. Another typical study found that pharmacist-led antimicrobial stewardship program had a lower mortality rate (19.3% vs 29.0%) and a lower multidrug-resistance (23.8% vs 31.7%) compared to the control group in a multicenter prospective cohort study on 577 patients [11].…”

Section: Introductionmentioning

confidence: 99%

Impact of Medical Professionals on Carbapenem-Resistant Pseudomonas Aeruginosa: Moderation Effect of Workload Based on the Panel Data in China

Han

Zhang

2019

Preprint

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Background: Antimicrobial resistance (AMR) causes serious increase in morbidity, mortality and costs, especially carbapenem-resistant Pseudomonas aeruginosa (CRPA). Medical professionals play an important role in tackling AMR. Available studies overlooked the impact of workload on medical professionals in the relationship between medical professionals and AMR. This study explored the relationship between medical professionals and CRPA rate and the moderation effect of medical professionals’ workload in this relationship from a macro perspective. Methods: Based on panel data in China, hierarchical regression analysis was used to explore moderation effect of workload on medical professionals and CRPA rate. Fixed-effect model was applied to estimate the moderation effect models. Medical professionals were measured by the numbers of physicians, registered nurses, pharmacists, clinical microbiologists per 1000 populations. Workload was measured by the number of daily visits of physicians. Results: The numbers of physicians, registered nurses, pharmacists and clinical technicians were signiﬁcant negative with CRPA rate (Coef. = -0.889, -0.775,-1.176, -0.822; P= 0.003, 0.003, 0.011, 0.007, respectively). Workload had significant positive moderation effect between physicians, registered nurses, pharmacists, clinical technicians and CRPA rate (Coef.= 1.270, 1.400, 2.210, 1.634; P=0.004, 0.001, 0.035, 0.003, respectively). Conclusions: Increasing medical professionals may help curb CRPA. Measures to reduce medical professionals’ workload should be implemented to improve CRPA performance further.

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Developing a theory-based behavior change intervention to improve the prescription of surgical prophylaxis

et al. 2021

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Antimicrobial resistance (AMR) is increasingly pervasive due to multiple, complex prescribing and consuming behaviours. Accordingly, behaviour change is an important component of response to AMR. Little is known about the best approaches to change antibiotic use practices and behaviours. This project aims to develop a context-specific behaviour change strategy focusing on promoting appropriate prescription practices following the World Health Organization recommendations for surgical prophylaxis. In an orthopaedic surgery unit in Egypt. The project included a formative qualitative research study with 31 in-depth interviews with orthopaedic surgeons that was based on the Theoretical Domains Framework (TDF) and an intervention that was developed to following the Behaviour Change Wheel (BCW) in a knowledge co-production workshop with ten public health experts that ensured that the theory based intervention was a culturally acceptable, practical and implementable intervention. The prescription of surgical prophylaxis was influenced by eight TDF domains from which workshop participants selected five to be included in the behaviour change intervention including, knowledge, belief in consequences (mistrust towards infection prevention and control measures), environmental factors (lack of prescription guidelines), professional role and reinforcement (a lack of appropriate follow up actions influenced prescription of surgical prophylaxis). The appropriate set of behaviour change functions of BCW and related activities to improve the current practices included education, enablement, persuasion, environmental restructuring and restriction. The study showed that a theory based, and context specific intervention can be created by using the TDF and BCW together with knowledge-co creation to improve the prescription of surgical prophylaxis in and Egyptian orthopaedic unit. The intervention needs to piloted and scaled up.

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Pharmacist-driven antimicrobial stewardship in intensive care units in East China: A multicenter prospective cohort study

Cited by 49 publications

References 20 publications

Implementasi Antimicrobial Stewardship Program di Kawasan Asia: Sebuah Kajian Sistematis

Implementasi Antimicrobial Stewardship Program di Kawasan Asia: Sebuah Kajian Sistematis

Impact of Medical Professionals on Carbapenem-Resistant Pseudomonas Aeruginosa: Moderation Effect of Workload Based on the Panel Data in China

Developing a theory-based behavior change intervention to improve the prescription of surgical prophylaxis

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