Maharjan Sanju, Gallagher Patrick, Gautam Manish, Gautam Sanjay, Budhathoki Manisha, Mukhiya Reena, Kattel Smirti, Bhandari Amit, Joh Hea Sun, Aboushady Ahmed Taha, Zellweger Raphaël M, Upadhyaya Madan Kumar, Jha Runa, Acharya Jyoti, MacWright William R, Marks Florian, Stelling John, Poudyal Nimesh
Anweshan Private Limited, Lalitpur, Nepal.
Public Health Surveillance Group LLC, New Jersey, United States of America.
PLoS One. 2025 Jul 1;20(7):e0326658. doi: 10.1371/journal.pone.0326658. eCollection 2025.
The International Vaccine Institute-led CAPTURA (Capturing Data on Antimicrobial Resistance Patterns and Trends in Use in Regions of Asia) project delivered capacity building activities to strengthen antimicrobial resistance surveillance activities in Nepal.
The CAPTURA project trained 97 laboratory personnel from 19 hospitals on the use of WHONET/BacLink software to manage microbiology data in Nepal during 2020-2021. Approximately two years later, the trainees were followed up by phone to assess implementation status and effectiveness of the training. An inductive approach was used for coding and categorization of their response, and themes were generated for analysis. Trainees from ten hospitals agreed to respond regarding their experience.
We found that two out of the ten hospitals were using the WHONET/BacLink software, with one each within and outside the national AMR surveillance network. The remaining eight hospitals never implemented the system despite receiving the training. Key barriers to implementation included, hospital administration prioritizing other interoperable software, limited ongoing training, inability to export data from an LIS, limited real-time assistance with technical issues, and poor confidence in analyzing data. In addition, limited human resources and minimal capacity-building activities resulted in a lack of confidence in using the system independently, which were also identified as barriers.
Implementing WHONET/BacLink software in hospital settings can be challenging due to various factors, including a lack of knowledge and confidence among users, a lack of time and human resources to use the software effectively, and a lack of interoperability with other hospital management systems. Real-time support and follow-up activities potentially reinforce the skills and knowledge delivered during the training.
由国际疫苗研究所牵头的CAPTURA（获取亚洲地区抗菌药物耐药模式及使用趋势数据）项目开展了能力建设活动，以加强尼泊尔的抗菌药物耐药监测活动。
CAPTURA项目在2020 - 2021年期间，对来自19家医院的97名实验室人员进行了关于使用WHONET/BacLink软件管理尼泊尔微生物学数据的培训。大约两年后，通过电话对学员进行随访，以评估培训的实施情况和效果。采用归纳法对他们的回答进行编码和分类，并生成主题进行分析。来自10家医院的学员同意就他们的经历做出回应。
我们发现，10家医院中有2家在使用WHONET/BacLink软件，其中一家在国家抗菌药物耐药监测网络内，另一家在网络外。其余8家医院尽管接受了培训，但从未实施该系统。实施的主要障碍包括，医院管理层优先考虑其他可互操作的软件、持续培训有限、无法从实验室信息系统导出数据、技术问题的实时协助有限以及数据分析信心不足。此外，人力资源有限和能力建设活动极少导致缺乏独立使用该系统的信心，这也被确定为障碍。
在医院环境中实施WHONET/BacLink软件可能具有挑战性，原因是多方面的，包括用户缺乏知识和信心、缺乏有效使用该软件的时间和人力资源，以及与其他医院管理系统缺乏互操作性。实时支持和后续活动可能会强化培训期间传授的技能和知识。
