The impact of COVID-19 on antimicrobial stewardship programme implementation in hospitals – an exploration informed by the Consolidated Framework for Implementation Research

Hashad, Nortan; Stewart, Derek; Perumal, Dhayaneethie; Razzaq, Najiba Abdul; Tonna, Antonella

doi:10.1016/j.jhin.2022.08.005

Cited by 4 publications

(4 citation statements)

References 29 publications

(39 reference statements)

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“…Participants reported challenges in building relationships with other departments during COVID-19 and attributed this to fewer in-person interactions. Similar results were obtained in interviews with AMS teams in the United Kingdom (UK) and the United Arab Emirates (UAE) during COVID-19 [6,7]. AMS teams in the UK reported difficulties in building relationships and working collaboratively, and in the UAE AMS teams found remote review of patients to be less effective than in-person rounds.…”

Section: Discussionsupporting

confidence: 60%

Antimicrobial Stewardship (AMS) During COVID-19: Eyes and Ears on the AMS Team

Dort

Penm

Ritchie

et al. 2023

Studies in Health Technology and Informatics

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Antimicrobial stewardship (AMS) programs in hospitals comprise coordinated strategies to optimise antimicrobial use. The COVID-19 pandemic had a significant impact on the healthcare system, including AMS. This study aimed to understand the work processes of AMS teams during COVID-19 hospital restrictions and the role technology played in supporting AMS. Observations and interviews were conducted with AMS teams at two hospitals in Sydney, Australia. Participants reported an increase in antimicrobial use, a loss of resources for AMS activities, and reduced in-person interactions. Meetings were performed through videoconferencing, which resulted in greater access to information but led to poorer communication and impacted interdisciplinary relationships. As COVID-19 restrictions recede, AMS program changes should be evaluated to understand the most effective strategies to facilitate evidence-based AMS practices.

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Section: Discussionsupporting

confidence: 60%

Antimicrobial Stewardship (AMS) During COVID-19: Eyes and Ears on the AMS Team

Dort

Penm

Ritchie

et al. 2023

Studies in Health Technology and Informatics

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“…Several recent studies reported an increase in antimicrobial usage during the COVID-19 pandemic due to various factors, including increased hospitalizations and heightened concerns about secondary infections [55][56][57][58]. Nevertheless, a recent study conducted in the UAE shed light on the adaptability of ASP teams and services in the country during the pandemic, with findings indicating the ability of ASP team members in the UAE to repurpose their roles to respond effectively to the unique COVID-19 challenges [59]. This adaptability was demonstrated through the involvement in developing national guidelines for the treatment of COVID-19 patients and the active contribution to guideline management and monitoring [59].…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, a recent study conducted in the UAE shed light on the adaptability of ASP teams and services in the country during the pandemic, with findings indicating the ability of ASP team members in the UAE to repurpose their roles to respond effectively to the unique COVID-19 challenges [59]. This adaptability was demonstrated through the involvement in developing national guidelines for the treatment of COVID-19 patients and the active contribution to guideline management and monitoring [59]. Despite the initial disruptions caused by the pandemic, a gradual restoration of ASP activities was reported by Hashad et al in the UAE, highlighting the resilience and commitment of healthcare professionals in maintaining ASP activities [59,60].…”

Section: Discussionmentioning

confidence: 99%

“…This adaptability was demonstrated through the involvement in developing national guidelines for the treatment of COVID-19 patients and the active contribution to guideline management and monitoring [59]. Despite the initial disruptions caused by the pandemic, a gradual restoration of ASP activities was reported by Hashad et al in the UAE, highlighting the resilience and commitment of healthcare professionals in maintaining ASP activities [59,60].…”

Section: Discussionmentioning

confidence: 99%

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Improving Antimicrobial Stewardship Program Using the Lean Six Sigma Methodology: A Descriptive Study from Mediclinic Welcare Hospital in Dubai, the UAE

Sallam,

Snygg

2023

Healthcare

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Background: Antimicrobial resistance (AMR) is one of the key challenges in healthcare, and effective antimicrobial stewardship programs (ASPs) can play a vital role to control it. The aim of the current study was to assess the impact of the Lean Six Sigma (LSS) methodology on a hospital-wide ASP. Methods: This retrospective descriptive study was conducted at Mediclinic Welcare Hospital (MWEL), Dubai, the United Arab Emirates (UAE). The critical-to-quality (CTQs) data were collected pre/post interventions, including leadership support, guideline implementation, and audits. The study focused on inpatients who received antimicrobials from January 2021 to July 2022, analyzing ASP metrics (utilization, processes, and outcome measures). Results: The ASP improvements led to an 81.7% decrease in hospital’s parenteral antimicrobial expenses from January 2021 to July 2022, and a 54.2% reduction in antimicrobial usage while maintaining clinical outcomes. The average defined daily dose per 100 bed-days drop of 12.5% further demonstrated this positive trend. The intervention was not accompanied by higher nosocomial infection rates, longer stays, or mortality. Additionally, intervention led to better compliance with surgical prophylaxis bundles, antimicrobial protocols, hand hygiene and other ASP CTQ metrics. Conclusions and recommendations: This study emphasized the significance of implementing the LSS methodology in addressing process variations, enhancing ASP outcomes, and reducing antimicrobial use. These findings can inform health policymakers to improve future ASP outcomes. Additionally, sustainability through continuous monitoring and ongoing education initiatives should be considered to ensure the long-term success of these improvements.

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