Adaptation and implementation of the ARK (Antibiotic Review Kit) intervention to safely and substantially reduce antibiotic use in hospitals: a feasibility study
| Autor: | Tim E. A. Peto, Elizabeth L. A. Cross, J. Islam, Fiona Mowbray, Martin J. Llewelyn, Marta Santillo, Anne-Sophie Walker, Lucy Yardley, Katy Sivyer |
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| Rok vydání: | 2019 |
| Předmět: |
Microbiology (medical)
Attitude of Health Personnel medicine.drug_class Antibiotics 030501 epidemiology law.invention Secondary care Antimicrobial Stewardship 03 medical and health sciences Randomized controlled trial Behavior Therapy law Intervention (counseling) medicine Humans Antimicrobial stewardship Antibiotic use Medical prescription antibiotic usage prescribing practice 0303 health sciences 030306 microbiology business.industry Post implementation General Medicine Patient Acceptance of Health Care medicine.disease Hospitals Anti-Bacterial Agents antimicrobial stewardship Infectious Diseases Feasibility Studies Physical and Mental Health Medical emergency 0305 other medical science business |
| Zdroj: | Cross, E L A, Sivyer, K, Islam, J, Santillo, M, Mowbray, F, Peto, T E A, Walker, A S, Yardley, L & Llewelyn, M J 2019, ' Adaptation and implementation of the ARK (Antibiotic Review Kit) intervention to safely and substantially reduce antibiotic use in hospitals : a feasibility study ', Journal of Hospital Infection, vol. 103, no. 3, pp. 268-275 . https://doi.org/10.1016/j.jhin.2019.07.017 Cross, E, Sivyer, K, Islam, J, Santillo, M, Mowbray, F, Peto, T, Walker, S, Yardley, L & Llewelyn, M 2019, ' Adaptation and implementation of the ARK (Antibiotic Review Kit) Intervention to safely and substantially reduce antibiotic use in hospitals: a feasibility study ', Journal of Hospital Infection, vol. 103, no. 3, pp. 268-275 . https://doi.org/10.1016/j.jhin.2019.07.017 |
| ISSN: | 0195-6701 |
| Popis: | Background Antimicrobial stewardship initiatives in secondary care depend on clinicians undertaking antibiotic prescription reviews but decisions to limit antibiotic treatment at review are complex. Aim To assess the feasibility and acceptability of implementing ARK (Antibiotic Review Kit), a behaviour change intervention made up of four components (brief online tool, prescribing decision aid, regular data collection and feedback process, and patient leaflet) to support stopping antibiotic treatment when it is safe to do so among hospitalised patients; before definitive evaluation through a stepped-wedge cluster randomised controlled trial. Methods Acceptability of the different intervention elements was assessed over 12-weeks by uptake of the online tool, adoption of the decision aid into prescribing practice, and rates of decisions to stop antibiotics at review (assessed through repeated point-prevalence surveys). Patient perceptions of the information leaflet were assessed through a brief questionnaire. Findings All elements of the intervention were successfully introduced into practice. A total of 132 staff encompassing a broad range of prescribers and non-prescribers completed the online tool (19.4 per 100 acute beds), including 97% (32/33) of the pre-specified essential clinical staff. Among 588 prescription charts evaluated in seven point prevalence surveys over the 12-week implementation period, 82% overall (76-90% at each survey) used the decision aid. The median antibiotic stop rate post implementation was 36% (range 29-40% at each survey) compared with 9% pre implementation (p Conclusion ARK provides a feasible and acceptable mechanism to support stopping antibiotics safely at post-prescription reviews in an acute hospital setting. |
| Databáze: | OpenAIRE |
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