Evidence map›Paper›PMID 36536350›Full record

ArticleBMC health services research2022

Implementation of an antimicrobial stewardship program in the Australian private hospital system: qualitative study of attitudes to antimicrobial resistance and antimicrobial stewardship.

Darshini Ayton, Eliza Watson, Juliana M Betts, Joseph Doyle, Benjamin Teh, Glenn Valoppi, Menino Cotta, Megan Robertson, Trisha Peel

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.7field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Review
  2. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 2 countries.

Darshini Ayton *Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Eliza Watson *Department of Infectious Diseases, Alfred Hospital and Central Clinical School, Monash University, Level 2, 85 Commercial Road, VIC, Melbourne, 3004, Australia.
Juliana M BettsDepartment of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Joseph DoyleDepartment of Infectious Diseases, Alfred Hospital and Central Clinical School, Monash University, Level 2, 85 Commercial Road, VIC, Melbourne, 3004, Australia.
Benjamin TehEpworth HealthCare, Melbourne, VIC, Australia.
Glenn ValoppiEpworth HealthCare, Melbourne, VIC, Australia.
Menino CottaUQCCR, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
Megan RobertsonEpworth HealthCare, Melbourne, VIC, Australia.
Trisha PeelDepartment of Infectious Diseases, Alfred Hospital and Central Clinical School, Monash University, Level 2, 85 Commercial Road, VIC, Melbourne, 3004, Australia. trisha.peel@monash.edu.
Monash University · AUEpworth Hospital · AUUniversity of Melbourne · AUUniversity of Queensland · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAntimicrobial Stewardship (AMS) is a key method to tackle antimicrobial resistance (AMR). In Australia, private hospitals have a higher rate of inappropriate prescribing and non-compliance with antimicrobial guidelines, yet this phenomenon is poorly described. Private hospitals make up 49% of hospitals in Australia, making it vital to understand AMS in this setting.

methodsThis study aimed to explore capabilities, opportunities and motivations for AMR and AMS with stakeholders at an Australian private hospital, and identify barriers and enablers 5 years post-implementation of an AMS program comparing with pre-implementation findings. A mixed-methods study was performed, involving three focus groups with stakeholders. All doctors, nurses and pharmacists at the hospital were invited to complete a survey on their experiences with and awareness of AMR, AMS and antimicrobial prescribing.

resultsThirteen staff took part in the focus groups, 100 staff responded to the survey. Staff understood the importance of the AMS program, but active engagement was low. Staff felt more thorough feedback and monitoring could improve prescribing behaviour, but acknowledged difficulty in private hospitals in changing habits of staff who valued autonomy in making prescribing decisions. Half of respondents felt the current AMS restrictions should continue. Executive engagement may be needed to drive system changes across a complex network.

conclusionAMS awareness increased post-implementation, but staff remained sceptical of its benefits. Engagement and education of medical consultants regarding local benefits of AMS must improve. Enhanced understanding of feedback provision, methods for engagement, and advocacy from leadership will ensure success and longevity for the program.

Indexed as

Anti-Infective AgentsAntimicrobial StewardshipAnti-Bacterial AgentsAustraliaDrug Resistance, BacterialHospitals, PrivateHumansAnti-Bacterial AgentsAnti-Infective AgentsAntimicrobial StewardshipPrivate healthcare facilityProgram evaluation

Identifiers

PMID36536350
PMCPMC9764684
OpenAlexW4311939661

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.