Assessment of Knowledge, Attitudes, and Practices (KAP) of Providers Towards Internal Reporting of Antimicrobial Use

BACKGROUND: Surveillance of antimicrobials is important to ensure appropriate practices. National mandatory reporting of antimicrobial utilization (AU) is anticipated. As feedback drives change, we surveyed providers to gain input on their perceptions about attribution, barriers to feedback, and preferences on AU feedback. METHODS: A 20-question, IRB-approved survey was emailed to providers who prescribe antimicrobials at Vanderbilt University Hospital. Demographics, methods of and barriers to feedback, and case scenarios addressing attribution upon admission from the emergency department (ED), transfer between inpatient teams and consultant interactions were collected. Levels of concern were rated on a scale of 1 to 5 regarding barriers. Participants were stratified by service line. Chi-square and Fisher’s exact test for categorical variables and analysis of variance for intergroup mean differences were conducted. RESULTS: A total of 211 (27.5%) of 766 providers completed the survey. Upon admission, 83% of providers attributed to the ED team that ordered the antimicrobial with no between group differences, P = 0.21. After ICU transfer and broadening of therapy, 91% attributed to the ICU team that changed therapy, P = 0.39 between groups. After a new ICU team came on service, 73.9% attribute the antibiotic changed the day prior to the new team, P = 0.98. A significant difference was seen in the consult scenario of attribution to Infectious Disease (ID) team (critical care 50%, ED 43.5%, ID 37.5%, other medicine specialties 60.2%, and surgery 77.8%, P = 0.01). Providers wanted reporting to be based on service (62%) and to be notified via email (73%) as opposed to an online dashboard (36%). Levels of concern on following another provider’s recommendations varied (ED 3.1 vs. ID 2.3, P < 0.001 across all groups) as well as unaccounted patient severity (ED 4.4 vs. Surgery 2.8, P < 0.001 across all groups). Services also differed in likelihood to change practice based on feedback (ED 3.8 vs. Medicine 3.2, P = 0.047 across all groups). CONCLUSION: There is a general agreement on attribution throughout a hospitalization with varying levels of concern between services regarding feedback of utilization data. This is important to take into consideration prior to implementation of feedback distribution to providers. DISCLOSURES: T. Lines, National Institutes of Health: Investigator, Clinical and Translational Science Award grant obtained only to provide survey participants with $5 incentive in completing the survey