ArticleBMC infectious diseases2026
Barriers and facilitators to implementing antimicrobial stewardship (AMS) in a Chinese tertiary hospital: a qualitative study based on the Consolidated Framework for Implementation Research (CFIR).
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
backgroundAlthough current evidence supports the effectiveness of antimicrobial stewardship (AMS), its sustained and effective implementation in tertiary hospitals remains challenging. This study aims to explore the facilitative and barrier factors influencing AMS implementation in a Chinese tertiary hospital, thereby providing insights to support the ongoing and effective promotion of AMS within tertiary healthcare institutions.
methodsBased on the Consolidated Framework for Implementation Research (CFIR), semi-structured interviews were conducted with 28 key stakeholders, including 15 physicians, 5 hospital managers, 4 pharmacists, 2 nurses, and 2 microbiologists. Data collection continued until data saturation was reached, defined as the point at which no new themes emerged across at least two consecutive interviews. The interview data were analyzed using directed content analysis to systematically code and categorize factors. Textual data were coded and categorized with NVivo 15 software.
resultsThis study identified 34 facilitative factors, 41 barrier factors, and 1 mixed determinant across 30 CFIR constructs. The distribution of these factors across the CFIR domains is uneven, with a marked concentration observed within the inner setting domain. Key facilitative factors include the establishment of a closed-loop management system, national policy support, multidisciplinary collaboration, and integration of clinical pharmacists into clinical departments. In contrast, major barrier factors include limited clinical adaptability of AMS programs, ambiguous role definition, insufficient available resources, insufficient relative priority, lagging policy management, challenges in interdepartmental collaboration, limited role perception among nurses, and limited knowledge of antibacterial agents among frontline physicians.
conclusionBy synthesizing the identified facilitative and barrier factors, this study suggests that sustainable AMS advancement in tertiary hospitals requires multi-dimensional alignment. While national policy and institutional measures facilitate AMS implementation, its long-term delivery still faces multiple challenges. These findings identify key constraints and provide empirical evidence for optimizing AMS in similar healthcare settings to support its long-term success.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.