What does antimicrobial stewardship look like where you are? Global narratives from participants in a massive open online course
| Autor: | Vrinda Nampoothiri, Candice Bonaconsa, Surya Surendran, Oluchi Mbamalu, Winnie Nambatya, Peter Ahabwe Babigumira, Raheelah Ahmad, Enrique Castro-Sanchez, Alex Broom, Julia Szymczak, Walter Zingg, Mark Gilchrist, Alison Holmes, Marc Mendelson, Sanjeev Singh, Monsey McLeod, Esmita Charani |
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| Přispěvatelé: | Economic & Social Research Council (ESRC), ESRC, National Institute for Health Research, University of Zurich, Charani, Esmita |
| Rok vydání: | 2021 |
| Předmět: |
microbial
SURGERY pharmacists education ownership 610 Medicine & health DECISION-MAKING health personnel Microbiology nurses medical 2726 Microbiology (medical) antibiotics decision making 10234 Clinic for Infectious Diseases PROGRAMS MIDDLE-INCOME COUNTRIES IMPLEMENTATION AcademicSubjects/MED00740 Pharmacology & Pharmacy patient knowledge 2403 Immunology Science & Technology drug resistance 2404 Microbiology 2725 Infectious Diseases economics CARE ANTIBIOTIC STEWARDSHIP QR antimicrobial stewardship Infectious Diseases AcademicSubjects/MED00290 HOSPITALS narrative discourse 2723 Immunology and Allergy surveillance Original Article LB AcademicSubjects/MED00230 Life Sciences & Biomedicine social sciences INTERVENTIONS |
| Zdroj: | JAC-Antimicrobial Resistance JAC-antimicrobial resistance |
| ISSN: | 2632-1823 |
| Popis: | Introduction\ud Whilst Antimicrobial Stewardship (AMS) is being implemented in different countries, different contexts continue to present unique challenges. We investigated the challenges to implementing AMS in different countries by examining comments from clinical, academic, and lay learners participating in a Massive Open Online Course (MOOC) on tackling antimicrobial resistance (AMR).\ud \ud Methods\ud A 3-week MOOC titled “Tackling AMR: A social science approach” was developed with a global faculty in collaboration with the British Society of Antimicrobial Chemotherapy and Imperial College London and launched in November 2019. Learners were asked specific questions about their experiences of AMS throughout the MOOC which included 38 optional free text prompts. Learners' free text responses from first three-course runs (November 2019 – July 2020) were collated and coded in NVivo 12 using a conventional content analysis approach to identify challenges to implementing AMS across countries. \ud \ud Results\ud Representing 114 countries, 1464 learners enrolled, with largest representation from the United Kingdom, India, Nigeria, Australia, and Pakistan. The learners described a range of AMS activities and team compositions. While recognising the importance of pharmacist and nurse roles in AMS, the learners reported that such roles remain ill-defined across countries, restricting the reach and potential of AMS strategies. A range of challenges to implementing AMS were described, including: limited awareness and engagement by the general public and healthcare workers (HCW) on the impact of AMR on human health, lack of adequate of governance and policy; inconsistencies in surveillance for antibiotic consumption and AMR, impeding feedback loops and improvement processes; human resource and technological constraints; variable access to key antibiotics; lack of ownership of antibiotic decision-making and buy-in from different clinical specialties. Patients’ knowledge, experiences and perspectives were recognised as a valuable source of information that needed to be incorporated in AMS initiatives to overcome cultural barriers to the judicious use of antibiotics. \ud \ud Conclusion\ud Analysis of learner comments and reflections identified a range of enablers and barriers to AMS implementation across different healthcare economies. Common challenges to AMS implementation included the role of non-physician health care professionals, resources, knowledge of AMR and patient engagement and involvement in AMS. |
| Databáze: | OpenAIRE |
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