Journal article
Antibiotic stewardship implementation at hospitals without on-site infectious disease specialists: A qualitative study
Infection control and hospital epidemiology, Vol.43(5), pp.576-581
05/2022
DOI: 10.1017/ice.2021.203
PMID: 33993897
Appears in UI Libraries Support Open Access
Abstract
Hospitals are required to have antibiotic stewardship programs (ASPs), but there are few models for implementing ASPs without the support of an infectious disease (ID) specialist, defined as an ID physician and/or ID pharmacist.
In this study, we sought to understand ASP implementation at hospitals that lack on-site ID support within the Veterans' Health Administration (VHA).
Using a mandatory VHA survey, we identified acute-care hospitals that lacked an on-site ID specialist. We conducted semistructured interviews with personnel involved in ASP activities.
The study was conducted across 7 VHA hospitals.
In total, 42 hospital personnel were enrolled in the study.
The primary responsibility for ASPs fell on the pharmacist champions, who were typically assigned multiple other non-ASP responsibilities. The pharmacist champions were more successful at gaining buy-in when they had established rapport with clinicians, but at some sites, the use of contract physicians and frequent staff turnover were potential barriers. Some sites felt that having access to an off-site ID specialist was important for overcoming institutional barriers and improving the acceptance of their stewardship recommendations. In general, stewardship champions struggled to mobilize institutional resources, which made it difficult to advance their programmatic goals.
In this study of 7 hospitals without on-site ID support, we found that ASPs are largely a pharmacy-driven process. Remote ID support, if available, was seen as helpful for implementing stewardship interventions. These findings may inform the future implementation of ASPs in settings lacking local ID expertise.
Details
- Title: Subtitle
- Antibiotic stewardship implementation at hospitals without on-site infectious disease specialists: A qualitative study
- Creators
- Daniel J Livorsi - Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IowaKenda R Stewart Steffensmeier - Center for Access & Delivery Research & Evaluation (CADRE), Iowa City Veterans' Affairs (VA) Health Care System, Iowa City, IowaEli N Perencevich - Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IowaMatthew Bidwell Goetz - David Geffen School of Medicine at the University of California in Los Angeles, Los Angeles, CaliforniaHeather Schacht Reisinger - Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa
- Resource Type
- Journal article
- Publication Details
- Infection control and hospital epidemiology, Vol.43(5), pp.576-581
- DOI
- 10.1017/ice.2021.203
- PMID
- 33993897
- NLM abbreviation
- Infect Control Hosp Epidemiol
- ISSN
- 0899-823X
- eISSN
- 1559-6834
- Publisher
- Cambridge University Press; United States
- Copyright
- © The Author(s), 2021
- Language
- English
- Electronic publication date
- 05/17/2021
- Date published
- 05/2022
- Academic Unit
- Infectious Diseases; Epidemiology; Center for Social Science Innovation; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984080378202771
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