What prevents the intravenous to oral antibiotic switch? A qualitative study of hospital doctors' accounts of what influences their clinical practice

Broom, Jennifer; Broom, Alex; Adams, Kate; Plage, Stefanie

doi:10.1093/jac/dkw129

Cited by 58 publications

(90 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It has been reported that there is often a failure in translating classroom knowledge into clinical prescribing practice, and there is discordance between knowledge and practice (Eyal and Cohen, 2006;Scaioli et al, 2015;Wasserman et al, 2017). More active educational approaches such as clinical case discussions and interactive elearning are generally considered to be more effective for influencing prescribing behaviours (Ohl and Luther, 2014;Broom et al, 2016;Wasserman et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

“…These concepts/strategies are utilized internationally (Shrahtey et al 2015;Broom et al, 2016;O'Donnell and Guarascio, 2017) and every veterinary undergraduate should be knowledgeable about them for obvious reasons: early switch from intravenous to oral AB reduces duration of AB therapy, length of hospital stay, intravenousassociated morbidity and improve cost effectiveness (Broom et al, 2016). De-escalation is a critical strategy in reducing resources (Minen et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, veterinarians are expected to be in the frontline of the fight against ABR (Castro-Sanchez et al, 2016;Brink, et al, 2017;Moran, 2017;Dyar et al, 2018). Optimization of AM prescribing is the best way to checkmate escalating ABR worldwide and to preserve AB for future generations (Broom et al, 2016;Moran, 2017). Interventions that strengthen the concept of 'One-Health' at the human-animal interface such as antibiotic stewardship (ABS), have been established the best strategy to contain ABR (Cisneros et al, 2014;Bowater, 2015;O'Donnel and Guarrascio, 2016;Wasserman et al, 2017).…”

Section: Study Design Site and Populationmentioning

confidence: 99%

See 2 more Smart Citations

Veterinary Medical Students’ Perceptions, Attitude and Knowledge about Antibiotic Resistance and Stewardship: How Prepared Are Our Future Prescribers?

et al. 2018

View full text Add to dashboard Cite

A cross sectional, multicentre survey utilizing a questionnaire was used to assess 6 th -(final-) year veterinary medical students' perceptions, attitude and knowledge about antibiotic resistance (ABR) and stewardship (ABS) in 5 convenientlyselected veterinary schools in Nigeria. Data obtained were analyzed by Fischer's exact and χ 2 tests at a significance level of P < 0.05. Out of 175 final-year veterinary students, 95 (54.3% i.e., response rate) completed the survey. Of the 95, 17% have heard about ABS and 7% knew the meaning of ABS. Less than 10% knew the core principles and goals of ABS and less than 20% of the respondents knew the ideal members of an ABS team. All the respondents rightly knew that no antibiotic stewardship programme (ASP) exist in veterinary hospitals in Nigeria, nearly all of them (97%) reported that antibiograms are rarely used during antibiotic (AB) prescription in their institutional veterinary teaching hospital (VTH) and about two-third (65%) believed that ABs are overused in most veterinary hospitals in Nigeria. Most of the respondents believed that ABR is of greater concern at national level than in their institutional VTHs and majority of them (92%) believed that ABR is a global problem (P = 0.009). Minority of the respondents knew that inadequate personal hygiene, use of substandard ABs, prescription of ABs by non-veterinarians/professionals, poor infection control practices, treating self-limiting infections with ABs, suboptimal and incomplete AB doses (P = 0.017), are factors that promote ABR. Minority of the respondents knew that education on AB therapy (44%), development of antibiotic usage policies (35%), reduction of AB use (14%), establishment of national AB resistance surveillance (28%) and development of institutional guidelines for AB use (29%), are critical interventions to curb ABR. Only 17% of the respondents felt that their education on ABR is adequate for their veterinary career. Most of the respondents believed that strong knowledge of ABs is important for their future veterinary career and would like more education about ABR and ABS. Overall mean correct score of 29% on clinical knowledge vignettes with similar scores across the schools in all the areas, was recorded. This survey has shown that Nigerian veterinary students' perception and knowledge about ABR and ABS are poor and therefore creates doubt about their preparedness to practice ABS. There is urgent need for improved ABS education in Nigerian veterinary schools.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Study Design Site and Populationmentioning

confidence: 99%

See 1 more Smart Citation

Veterinary Medical Students’ Perceptions, Attitude and Knowledge about Antibiotic Resistance and Stewardship: How Prepared Are Our Future Prescribers?

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Further research is needed to determine what proportion of patients receive IV antibiotics which could be administered orally. Prompt scheduled transfer to oral antibiotics when clinically indicated would reduce the need for PIVC and associated morbidity (Broom, Broom, Adams, & Plage, ).…”

Section: Discussionmentioning

confidence: 99%

The prevalence of peripheral intravenous cannulae and pattern of use: A point prevalence in a private hospital setting

Wong

Cooper

Brown

et al. 2017

Journal of Clinical Nursing

View full text Add to dashboard Cite

Aims and objectives:To determine the prevalence and pattern of use of peripheral intravenous cannulae in hospital wards.Background: Peripheral intravenous cannulae are commonly used in acute health care to directly access the bloodstream for the administration of medications, intravenous fluids and blood products. Peripheral intravenous cannulae are associated with multiple adverse events including hospital-acquired bloodstream infection, thrombophlebitis and pain/discomfort. Administration of intravenous fluids is associated with impaired mobility and nocturia which may increase falls risk in the older people.Design: Observational, point prevalence study.Methods: Three private hospitals comprising a total of 1,230 beds participated in the study. Nurses recorded the presence of a peripheral intravenous cannulae, duration of insertion, state of the dressing and whether the peripheral intravenous cannulae was accessed in the previous 24 hr and for what purpose. Nurses were also asked whether they would replace the peripheral intravenous cannulae should it fail.Results: Approximately one-quarter of patients had a peripheral intravenous cannulae, the majority of which had been present for <24 hr. The major use of the peripheral intravenous cannulae was antibiotic administration. Administration of intravenous fluids occurred in the presence of normal oral fluid intake. Nurses would not replace one-third of peripheral intravenous cannulae in the event of failure. A majority of patients were at increased falls risk, and one-third of these were receiving intravenous fluids. Relevance to clinical practice: Vigilance is required in the use of peripheral intravenous cannulae. Consider transition of medication administration to oral intake

show abstract

“…In addition, such use is more expensive to healthcare systems through higher antibiotic costs, increased length of hospital stay and increased nursing time 2. Although these risks are well described, a perception of greater potency and mythical qualities of intravenous antibiotics may prevent prompt intravenous to oral switching 3. Therefore, there is a need to balance the actual benefit of intravenous antibiotics against the known risks.…”

mentioning

confidence: 99%

Challenging the supremacy of intravenous antibiotics

Powell

Wilcock

2018

DTB

View full text Add to dashboard Cite

What prevents the intravenous to oral antibiotic switch? A qualitative study of hospital doctors' accounts of what influences their clinical practice

Cited by 58 publications

References 28 publications

Veterinary Medical Students’ Perceptions, Attitude and Knowledge about Antibiotic Resistance and Stewardship: How Prepared Are Our Future Prescribers?

Veterinary Medical Students’ Perceptions, Attitude and Knowledge about Antibiotic Resistance and Stewardship: How Prepared Are Our Future Prescribers?

The prevalence of peripheral intravenous cannulae and pattern of use: A point prevalence in a private hospital setting

Challenging the supremacy of intravenous antibiotics

Contact Info

Product

Resources

About