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Evaluating antibiotic stewardship in a tertiary care hospital in Kerala, India: a qualitative interview study
OBJECTIVES: To determine what barriers and facilitators to antibiotic stewardship exist within a healthcare facility. SETTING: 1300-bed tertiary care private hospital located in the state of Kerala, India. PARTICIPANTS: 31 semistructured interviews and 4 focus groups with hospital staff ranging from...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6530383/ https://www.ncbi.nlm.nih.gov/pubmed/31092653 http://dx.doi.org/10.1136/bmjopen-2018-026193 |
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author | Baubie, Kelsey Shaughnessy, Catherine Kostiuk, Lia Varsha Joseph, Mariam Safdar, Nasia Singh, Sanjeev K Siraj, Dawd Sethi, Ajay Keating, Julie |
author_facet | Baubie, Kelsey Shaughnessy, Catherine Kostiuk, Lia Varsha Joseph, Mariam Safdar, Nasia Singh, Sanjeev K Siraj, Dawd Sethi, Ajay Keating, Julie |
author_sort | Baubie, Kelsey |
collection | PubMed |
description | OBJECTIVES: To determine what barriers and facilitators to antibiotic stewardship exist within a healthcare facility. SETTING: 1300-bed tertiary care private hospital located in the state of Kerala, India. PARTICIPANTS: 31 semistructured interviews and 4 focus groups with hospital staff ranging from physicians, nurses, pharmacists and a clinical microbiologist. RESULTS: Key facilitators of antibiotic stewardship (AS) at the hospital included a dedicated committee overseeing appropriate inpatient antibiotic use, a prompt microbiology laboratory, a high level of AS understanding among staff, established guidelines for empiric prescribing and an easily accessible antibiogram. We identified the following barriers: limited access to clinical pharmacists, physician immunity to change regarding stewardship policies, infrequent antibiotic de-escalation, high physician workload, an incomplete electronic medical record (EMR), inadequate AS programme (ASP) physical visibility and high antibiotic use in the community. CONCLUSIONS: Opportunities for improvement at this institution include increasing accessibility to clinical pharmacists, implementing strategies to overcome physician immunity to change and establishing a more accessible and complete EMR. Our findings are likely to be of use to institutions developing ASPs in lower resource settings. |
format | Online Article Text |
id | pubmed-6530383 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-65303832019-06-07 Evaluating antibiotic stewardship in a tertiary care hospital in Kerala, India: a qualitative interview study Baubie, Kelsey Shaughnessy, Catherine Kostiuk, Lia Varsha Joseph, Mariam Safdar, Nasia Singh, Sanjeev K Siraj, Dawd Sethi, Ajay Keating, Julie BMJ Open Global Health OBJECTIVES: To determine what barriers and facilitators to antibiotic stewardship exist within a healthcare facility. SETTING: 1300-bed tertiary care private hospital located in the state of Kerala, India. PARTICIPANTS: 31 semistructured interviews and 4 focus groups with hospital staff ranging from physicians, nurses, pharmacists and a clinical microbiologist. RESULTS: Key facilitators of antibiotic stewardship (AS) at the hospital included a dedicated committee overseeing appropriate inpatient antibiotic use, a prompt microbiology laboratory, a high level of AS understanding among staff, established guidelines for empiric prescribing and an easily accessible antibiogram. We identified the following barriers: limited access to clinical pharmacists, physician immunity to change regarding stewardship policies, infrequent antibiotic de-escalation, high physician workload, an incomplete electronic medical record (EMR), inadequate AS programme (ASP) physical visibility and high antibiotic use in the community. CONCLUSIONS: Opportunities for improvement at this institution include increasing accessibility to clinical pharmacists, implementing strategies to overcome physician immunity to change and establishing a more accessible and complete EMR. Our findings are likely to be of use to institutions developing ASPs in lower resource settings. BMJ Publishing Group 2019-05-14 /pmc/articles/PMC6530383/ /pubmed/31092653 http://dx.doi.org/10.1136/bmjopen-2018-026193 Text en © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Global Health Baubie, Kelsey Shaughnessy, Catherine Kostiuk, Lia Varsha Joseph, Mariam Safdar, Nasia Singh, Sanjeev K Siraj, Dawd Sethi, Ajay Keating, Julie Evaluating antibiotic stewardship in a tertiary care hospital in Kerala, India: a qualitative interview study |
title | Evaluating antibiotic stewardship in a tertiary care hospital in Kerala, India: a qualitative interview study |
title_full | Evaluating antibiotic stewardship in a tertiary care hospital in Kerala, India: a qualitative interview study |
title_fullStr | Evaluating antibiotic stewardship in a tertiary care hospital in Kerala, India: a qualitative interview study |
title_full_unstemmed | Evaluating antibiotic stewardship in a tertiary care hospital in Kerala, India: a qualitative interview study |
title_short | Evaluating antibiotic stewardship in a tertiary care hospital in Kerala, India: a qualitative interview study |
title_sort | evaluating antibiotic stewardship in a tertiary care hospital in kerala, india: a qualitative interview study |
topic | Global Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6530383/ https://www.ncbi.nlm.nih.gov/pubmed/31092653 http://dx.doi.org/10.1136/bmjopen-2018-026193 |
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