Monitoring, documenting and reporting the quality of antibiotic use in the Netherlands: a pilot study to establish a national antimicrobial stewardship registry.

Autor:	Berrevoets MA; Department of Internal Medicine, Division of Infectious Diseases, Radboud university medical center, Nijmegen, The Netherlands. marvin.berrevoets@radboudumc.nl.; Radboud Center for Infectious Diseases, Radboud university medical center, Nijmegen, The Netherlands. marvin.berrevoets@radboudumc.nl., Ten Oever J; Department of Internal Medicine, Division of Infectious Diseases, Radboud university medical center, Nijmegen, The Netherlands.; Radboud Center for Infectious Diseases, Radboud university medical center, Nijmegen, The Netherlands., Sprong T; Department of Internal Medicine, Division of Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands., van Hest RM; Department of Hospital Pharmacy & Clinical Pharmacology, Academic Medical Center, Amsterdam, The Netherlands., Groothuis I; Department of Internal Medicine, Zuiderzee Medical Center, Lelystad, The Netherlands., van Heijl I; Department of Clinical Pharmacy, Tergooi Hospital, Hilversum, The Netherlands., Schouten JA; Scientific Institute for Quality of Healthcare, Radboud university medical center, Nijmegen, The Netherlands., Hulscher ME; Scientific Institute for Quality of Healthcare, Radboud university medical center, Nijmegen, The Netherlands.; Radboud Center for Infectious Diseases, Radboud university medical center, Nijmegen, The Netherlands., Kullberg BJ; Department of Internal Medicine, Division of Infectious Diseases, Radboud university medical center, Nijmegen, The Netherlands.; Radboud Center for Infectious Diseases, Radboud university medical center, Nijmegen, The Netherlands.
Jazyk:	angličtina
Zdroj:	BMC infectious diseases [BMC Infect Dis] 2017 Aug 15; Vol. 17 (1), pp. 565. Date of Electronic Publication: 2017 Aug 15.
DOI:	10.1186/s12879-017-2673-5
Abstrakt:	Background: The Dutch Working Party on Antibiotic Policy is developing a national antimicrobial stewardship registry. This registry will report both the quality of antibiotic use in hospitals in the Netherlands and the stewardship activities employed. It is currently unclear which aspects of the quality of antibiotic use are monitored by antimicrobial stewardship teams (A-teams) and can be used as indicators for the stewardship registry. In this pilot study we aimed to determine which stewardship objectives are eligible for the envisioned registry. Methods: We performed an observational pilot study among five Dutch hospitals. We assessed which of the 14 validated stewardship objectives (11 process of care recommendations and 3 structure of care recommendations) the A-teams monitored and documented in individual patients. They provided, where possible, data to compute quality indicator (QI) performance scores in line with recently developed QIs to measure appropriate antibiotic use in hospitalized adults for the period of January 2015 through December 2015 RESULTS: All hospitals had a local antibiotic guideline describing recommended antimicrobial use. All A-teams monitored the performance of bedside consultations in Staphylococcus aureus bacteremia and the prescription of restricted antimicrobials. Documentation and reporting were the best for the use of restricted antimicrobials: 80% of the A-teams could report data. Lack of time and the absence of an electronic medical record system enabling documentation during the daily work flow were the main barriers hindering documentation and reporting. Conclusions: Five out of 11 stewardship objectives were actively monitored by A-teams. Without extra effort, 4 A-teams could report on the quality of use of restricted antibiotics. Therefore, this aspect of antibiotic use should be the starting point of the national antimicrobial stewardship registry. Our registry is expected to become a powerful tool to evaluate progress and impact of antimicrobial stewardship programs in hospitals.
Databáze:	MEDLINE
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