Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban 4041, South Africa.
Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa.
J Med Microbiol. 2024 Jul;73(7). doi: 10.1099/jmm.0.001853.
Antimicrobial resistance (AMR) is recognized as an important global health risk, associated with increased mortality, morbidity and healthcare costs. Antimicrobial stewardship (AMS) involves a coherent set of processes that promote the rational use of antimicrobials. An AMS programme should be adapted and developed according to the available resources of a facility. This requires an analysis of the core AMS elements that are already in place and the resources available. This study aimed to assess the readiness of a tertiary healthcare facility and staff towards implementing an antimicrobial stewardship programme (ASP). This study focused on two aspects during an AMS pre-implementation phase. A situational or strengths, weaknesses, opportunities, and threats analysis was conducted based on (1) a questionnaire on attitudes and perceptions of pharmacists, clinicians and nurses towards AMR and AMS and (2) a situational analysis on the readiness of the facility. The questionnaire, which was available for completion between September 2021 and December 2021, was sent to a total of 3100 healthcare professionals (HCPs). Thirty-two (1.0 %) HCPs comprising 2 pharmacists, 16 clinicians and 14 nurses completed the questionnaire. Of the total participants, 31 (96.9 %) viewed AMR as a problem in South African hospitals and 29 (90.6 %) perceived AMR as a problem at their facility. The majority ( = 29, 90.6 %) of the participants were familiar with the term AMS, and 26 (81.3 %) participants agreed to willingly participate in any initiatives involving antimicrobial use at the facility. The situational analysis depicted existing strengths in terms of AMS structures such as the formation of an AMS committee and information and technology systems at the HCP's disposal. Weaknesses included the limited number of AMS activities being carried out and poor participation from HCPs within the AMS team. A pre-implementation phase in the building of an ASP can greatly assist in finding gaps for improvement, which can then be addressed in the implementation phase. Furthermore, the pre-implementation phase provides a baseline to measure improvements once the implementation phase has been instituted.
抗微生物药物耐药性（AMR）被认为是一个重要的全球健康风险，与死亡率、发病率和医疗保健成本增加有关。抗菌药物管理（AMS）涉及一系列促进合理使用抗菌药物的连贯流程。AMS 方案应根据设施的可用资源进行调整和开发。这需要分析已经到位的核心 AMS 要素和可用资源。本研究旨在评估一家三级保健设施及其工作人员在实施抗菌药物管理计划（ASP）方面的准备情况。本研究在 AMS 实施前阶段重点关注两个方面。基于（1）药剂师、临床医生和护士对 AMR 和 AMS 的态度和看法的问卷，以及（2）设施准备情况的情景分析，进行了情况或优势、劣势、机会和威胁分析。该问卷于 2021 年 9 月至 12 月期间可供填写，共发送给 3100 名医疗保健专业人员（HCP）。共有 32 名（1.0%）HCP 完成了问卷，包括 2 名药剂师、16 名临床医生和 14 名护士。在所有参与者中，31 人（96.9%）认为 AMR 是南非医院的一个问题，29 人（90.6%）认为 AMR 是他们所在设施的一个问题。大多数（=29，90.6%）参与者熟悉 AMS 一词，26 名（81.3%）参与者同意愿意参与任何涉及设施中抗菌药物使用的举措。情景分析描绘了 AMS 结构方面的现有优势，例如 AMS 委员会的形成以及 HCP 可利用的信息和技术系统。不足之处包括开展的 AMS 活动数量有限以及 AMS 团队中 HCP 的参与度低。在建立 ASP 的实施前阶段可以极大地帮助发现需要改进的差距，然后可以在实施阶段解决这些差距。此外，实施前阶段为实施阶段后衡量改进提供了一个基准。
