Black Emily K, MacDonald Lindsay, Neville Heather L, Abbass Kim, Slayter Kathryn, Johnston Lynn, Sketris Ingrid
, BSc(Pharm), ACPR, PharmD, is with the College of Pharmacy, Dalhousie University, Halifax, Nova Scotia.
, BSc(Pharm), was, at the time of this study, a student with the College of Pharmacy, Dalhousie University, Halifax, Nova Scotia. She is now a pharmacy intern at the Chaleur Regional Hospital in Bathurst, New Brunswick.
Can J Hosp Pharm. 2019 Jul-Aug;72(4):263-270. Epub 2018 Aug 31.
Antimicrobial use is the major factor in the development of antimicrobial resistance. Antimicrobial stewardship has been recommended as a strategy to improve antimicrobial use.
To learn about health care providers' perceptions of current antimicrobial use and stewardship, including barriers and facilitators to improving antimicrobial use at acute care hospitals in Nova Scotia.
This qualitative research study was conducted at acute care hospitals in Nova Scotia using focus groups and semistructured interviews. Health care providers (nurses, nurse practitioners, pharmacists, pharmacy students, and physicians) were invited to participate. Focus groups and interviews were conducted at each participant's place of employment. Interviews and focus groups were facilitated with an interview guide, audio-recorded, and transcribed verbatim. Transcripts were independently coded by 2 investigators and analyzed using thematic analysis.
A total of 9 focus groups and 3 individual interviews were conducted between June and August 2017. Fifty-four health care professionals and trainees (24 pharmacists and pharmacy students, 14 physicians, and 16 nurses and nurse practitioners) from 5 hospitals participated. The following themes were identified: current practices, prescribing influences, access to information, collaboration and communication, resources, and antimicrobial stewardship. Within each theme, barriers and facilitators to improving antimicrobial use were identified as subthemes.
Participants identified current barriers to appropriate use of antimicrobials and suggested facilitators that might improve the use of these drugs. The results of this study could be used by antimicrobial stewardship teams and decision-makers to improve antimicrobial use and stewardship initiatives throughout Nova Scotia, and may be applicable to hospitals outside the province.
抗菌药物的使用是导致抗菌药物耐药性产生的主要因素。抗菌药物管理已被推荐为改善抗菌药物使用的一项策略。
了解医疗服务提供者对当前抗菌药物使用及管理的看法，包括新斯科舍省急症护理医院在改善抗菌药物使用方面的障碍和促进因素。
这项定性研究在新斯科舍省的急症护理医院开展，采用焦点小组和半结构化访谈。邀请医疗服务提供者（护士、执业护士、药剂师、药学专业学生和医生）参与。焦点小组和访谈在每位参与者的工作场所进行。访谈和焦点小组讨论依据访谈指南进行，进行录音并逐字转录。转录文本由两名研究人员独立编码，并采用主题分析法进行分析。
2017年6月至8月期间共开展了9次焦点小组讨论和3次个人访谈。来自5家医院的54名医疗专业人员和实习生（24名药剂师和药学专业学生、14名医生、16名护士和执业护士）参与其中。确定了以下主题：当前做法、处方影响因素、信息获取、协作与沟通、资源以及抗菌药物管理。在每个主题中，确定了改善抗菌药物使用的障碍和促进因素作为子主题。
参与者指出了当前在合理使用抗菌药物方面存在的障碍，并提出了可能改善这些药物使用情况的促进因素。本研究结果可供抗菌药物管理团队和决策者用于改善新斯科舍省各地的抗菌药物使用和管理举措，可能也适用于该省外的医院。
