Organization and training at national level of antimicrobial stewardship and infection control activities in Europe: an ESCMID cross-sectional survey

Saudi hospitals and healthcare facilities are facing increasing rates of antimicrobial resistance and the emergence of new multi-drug resistant strains. This is placing an unprecedented threat to successful treatments and outcomes of patients accessing those facilities. The inappropriate use of antimicrobials is fueling this crisis, warranting urgent implementation of interventions to preserve antimicrobials and reduce resistance rates. Antimicrobial stewardship programmes (ASPs) can improve antimicrobial use, treatment success rates and reduce the levels of antimicrobial resistance. The Saudi Ministry of Health (MOH) devised a national antimicrobial stewardship plan to implement ASPs in hospitals, but little is known about the progress of implementation and the factors affecting it. This study aims to assess the level and the factors affecting the adoption and implementation of ASPs in Saudi hospitals at a national level. A nationwide cross-sectional survey was conducted in 2017 using an online questionnaire sent to all MOH hospitals. Overall, 147 out 247 MOH hospitals responded to the survey (54%). Only 26% of the hospitals reported the implementation of ASPs. Hospitals lack the knowledge, technological and staff resources to adopt and implement ASPs. Alternative models of ASP adoption could be explored to improve the rates of implementation of ASPs.

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Self-perceived competence and training needs analysis on antimicrobial stewardship among government ward pharmacists in Malaysia

JAC-Antimicrobial Resistance ◽

10.1093/jacamr/dlaa035 ◽

2020 ◽

Vol 2 (3) ◽

Author(s):

Cherh Yun Teoh ◽

Adliah Mhd. Ali ◽

Noraida Mohamed Shah ◽

Rohana Hassan ◽

Chee Lan Lau

Keyword(s):

Antimicrobial Stewardship ◽

Response Rate ◽

Perceived Competence ◽

Perceived Barriers ◽

Learning Needs ◽

Barriers To Learning ◽

Cross Sectional Survey ◽

Learning Methods ◽

Cross Sectional ◽

And Training

Abstract Background There is a paucity of data on pharmacists’ competency and learning needs in antimicrobial stewardship (AMS). Objectives To identify and prioritize learning needs based on self-perceived competence of ward pharmacists in AMS, to identify predictors of self-perceived competence, learning methods in AMS and perceived barriers to learning. Methods A cross-sectional survey involving ward pharmacists from Hospital Canselor Tuanku Muhriz (HCTM) and hospitals under the Ministry of Health was conducted from May to July 2018. Results A total of 553 ward pharmacists from 67 hospitals responded to this survey (71.3% response rate). Knowledge of infections, antimicrobials and AMS systems, confidence to advise on various issues relating to antimicrobial therapy and participation in clinical audit and evaluation were among the learning needs identified (median score 3.00). Meanwhile, knowledge on the epidemiology of infections, off-label use of antimicrobials and pharmacoeconomics relating to antimicrobials had lower median scores (2.00) and were thus prioritized as high learning needs. Significant predictors of self-perceived competence in AMS were: gender (P < 0.001); prior specific training in infections and AMS (P < 0.001); postgraduate degree (P < 0.001); practising in the area of infectious disease (P < 0.05); and years of working experience as a ward pharmacist (P < 0.005). Continuing medical education, seminars, courses and workshops were the most common (78.1%) and preferred (84.6%) learning methods in AMS. Lack of appropriate training (67.8%), time (44.5%) and funding (42.5%) topped the list of barriers to learning in AMS. Conclusions Findings in this study suggest the need to establish and intensify standardized training in AMS among government ward pharmacists.

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Education and training of nurses in the use of advanced medical technologies in home care related to patient safety: a cross-sectional survey.

Nurse Education Today ◽

10.1016/j.nedt.2021.104813 ◽

2021 ◽

pp. 104813

Author(s):

Ingrid ten Haken ◽

Somaya Ben Allouch ◽

Wim H. van Harten

Keyword(s):

Patient Safety ◽

Home Care ◽

Education And Training ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Medical Technologies ◽

And Training

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Implementation of an Antimicrobial Stewardship Program in Five Colombian Hospitals in 2018

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.842 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s273-s273

Author(s):

Christian Pallares ◽

María Virginia Villegas Botero

Keyword(s):

Infection Control ◽

Antimicrobial Stewardship ◽

Control Strategies ◽

Education And Training ◽

Public Hospitals ◽

International Standards ◽

International Consensus ◽

Stewardship Program ◽

And Training

Background: More than 50% of antibiotics used in hospitals are unnecessary or inappropriate. The antimicrobial stewardship programs (ASPs) are coordinated efforts to promote the rational and effective use of antibiotics including appropriate selection, dosage, administration, and duration of therapy. When an ASP integrates infection control strategies, it is possible to decrease the transmission of multidrug-resistant pathogens. Methods: In 2018, 5 Colombian hospitals were selected to implement an ASP. Private and public hospitals from different cities were included in the study, ranging from 200 to 700 beds. Our team, consisting of an infectious disease and hospital epidemiologist, visited each hospital to establish the baseline of their ASP program, to define the ASP outcomes according to each hospital’s needs, and to set goals for ASP outcomes in the following 6–12 months. Follow-up was scheduled every 2 months through Skype video conference. The baseline diagnosis or preintervention evaluation was done using a tool adapted from previous reports (ie, international consensus and The Joint Commission international standards). Documentation related to ASPs, such as microbiological profiles, antimicrobial guidelines (AMG) and indicators for the adherence to them as well as antimicrobial resistance (AMR) prevention through protocols, were written and/or updated. Prevention and infection control requirements and protocols were also updated, and cleaning and antiseptic policies were created. Training in rational use of antibiotic, infection control and prevention, and cleaning and disinfection were carried out with the healthcare workers in each institution. Results: Before the intervention, the development of the ASP according to the tool was 27% (range, 5%–47%). The lowest institutional scores were the item related to ASP feedback and reports (11% on average), followed by education and training (14%), defined ASP responsibilities (23%), ASP function according to priorities (26%), and AMR surveillance (27%). After the intervention, the ASP development increased to 57% (range, 39%–81%) in the hospitals. The highest scores achieved were for education and training (90%), surveillance (75%), and the activities of the infection control committee (70%). The items that made the greatest contribution to ASP development were the individual antibiogram, including the bacteria resistance profile, and the development of the AMG based on the local epidemiology in each hospital. Conclusions: The implementation of an ASP should include training and education as well as defining outcomes according to the hospital’s needs. Once the strategy is implemented, follow-up is key to achieving the goals.Funding: NoneDisclosures: None

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Translating Research into Practice in Low-Resource Countries: Progress in Prevention of Maternal to Child Transmission of HIV in Nigeria

Nursing Research and Practice ◽

10.1155/2013/848567 ◽

2013 ◽

Vol 2013 ◽

pp. 1-10 ◽

Cited By ~ 5

Author(s):

Y. Ogbolu ◽

E. N. Iwu ◽

S. Zhu ◽

J. V. Johnson

Keyword(s):

Mixed Models ◽

Infant Feeding Practices ◽

Child Transmission ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Medical Facilities ◽

Care Practices ◽

Sub Saharan ◽

And Training ◽

Research And Policy

Background.Research related to prevention of maternal to child transmission (PMTCT) of HIV is dynamic and rapidly changing and has provided evidence-based interventions and policies for practitioners. However, it is uncertain that research and policy guidelines are adequately being disseminated and implemented in resource-constrained countries with the largest burden PMTCT. This study examined current PMTCT practices in 27 public health facilities in Nigeria.Methods.A cross-sectional survey of 231 practicing nurses was conducted. Current PMTCT care practices were evaluated and compared to WHO and national PMTCT policy guidelines. Linear mixed models evaluated the association between PMTCT care practices and training in PMTCT.Results.Most nurses (80%) applied practices involving newborn prophylaxis; yet significant gaps in maternal intrapartum treatment and infant feeding practices were identified. PMTCT training explained 25% of the variance in the application of PMTCT care practices.Conclusion.Key PMTCT practices are not being adequately translated from research into practice. Researchers, policymakers, and clinicians could apply the study findings to address significant knowledge translation gaps in PMTCT. Strategies derived from an implementation science perspective are suggested as a means to improve the translation of PMTCT research into practice in Sub-Saharan African medical facilities.

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Training interns in nutrition and dietetics: a cross-sectional study of the barriers and motivators to being a Registered Dietitian Nutritionist preceptor

BMC Medical Education ◽

10.1186/s12909-021-02700-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Andrea M. Hutchins ◽

Donna M. Winham ◽

Jinette P. Fellows ◽

Michelle M. Heer

Keyword(s):

Experiential Learning ◽

Professional Training ◽

Online Survey ◽

Selection Process ◽

National Level ◽

Cross Sectional Study ◽

Registered Dietitian ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Entry Level

Abstract Background As is common across the health professions, training of Registered Dietitian Nutritionists (RDNs) requires experiential learning for interns/students to gain skills and demonstrate entry-level competency. Preceptors are essential to the experiential learning component of health care professional training, providing supervision and mentoring as students and interns gain the skills required for entry-level practice competency. Over the past 27 years, 47–73% of applicants to dietetic internships have received a placement. Practitioners willing to volunteer as preceptors are needed to generate more internship or experiential learning opportunities for the profession to continue to meet workforce demands. Methods The objective of this national-level online cross-sectional survey was to identify perceptions and attitudes associated with the preceptor role and incentives that might encourage precepting by current RDNs. A random sample of RDN and Nutrition and Dietetic Technicians, Registered (NDTR) professionals from the Commission on Dietetic Registration credentialed practitioner database were eligible to participate in the online survey. The main outcome measures included perceptions, attitudes, and preferred incentives to precept compared by preceptor experience categories (current, former, never precepted). Comparisons of perceptions, attitudes, and preferred incentives were made between preceptor experience categories using Chi-square and ANOVA. Results Of 2464 invitations, 308 participants had complete variables for analysis. Top incentives were the opportunity to earn continuing education units (65.9%) and having expenses paid to attend a national conference (49.5%). Significantly more (P < 0.001) “former” and “never” preceptors reported the ability to choose when to take an intern, training on how to teach and communicate with interns, and access to an “on-call” specialist as incentives compared to “current” preceptors. Significantly more (P < 0.01) “never” preceptors reported training on internship expectations and the ability to provide input on intern selection process as incentives compared to “current” or “former” preceptors. Conclusions Incentives to serve as a preceptor differ based on “current”, “former”, or “never” precepted status. Promoting and strategizing solutions to the current imbalance between the greater number of dietetic internship applicants compared to preceptors should be targeted based on preceptor status to retain current preceptors, encourage former preceptors to return and recruit professionals who have never served.

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Obesity in Saudi Arabia in 2020: Prevalence, Distribution, and Its Current Association with Various Health Conditions

Healthcare ◽

10.3390/healthcare9030311 ◽

2021 ◽

Vol 9 (3) ◽

pp. 311

Author(s):

Nora A. Althumiri ◽

Mada H. Basyouni ◽

Norah AlMousa ◽

Mohammed F. AlJuwaysim ◽

Rasha A. Almubark ◽

...

Keyword(s):

Saudi Arabia ◽

National Level ◽

Sampling Technique ◽

Health Conditions ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Age And Gender ◽

Prevalence Of Obesity ◽

And Gender ◽

Colon Diseases

The global prevalence of obesity is increasing. Obesity is associated with many chronic diseases and health conditions. This study aims to estimate the current prevalence of obesity in Saudi Arabia and described the current national-level status of the association between obesity and various health conditions. This study is a nationwide cross-sectional survey conducted over phone-interviews in June 2020. In this study, a proportional quota-sampling technique was used to obtain equal distributions of participants, stratified by age and gender, across the 13 regions of Saudi Arabia. Weight and height were self-reported, and the obesity was determined as BMI ≥ 30. Logistic regression adjusted for age and gender was used for exploring current associations between obesity and health conditions. Of the 6239 participants contacted, 4709 participants responded and completed the interview with a response rate of 75.48%. Of them, 50.1% were female, the mean age was 36.4 ± 13.5 (Range: 18–90), and the median age was 36. The national weighted prevalence of obesity (BMI ≥ 30) was 24.7%, and the prevalence in the sample (unweighted) was 21.7%. Obesity was significantly associated with type 2 diabetes [Odd ratio, (OR) = 1.52], hypercholesterolemia (OR = 1.69), hypertension (OR = 1.61), lung diseases (OR = 1.69), rheumatoid arthritis (OR = 1.57), sleep apnea (OR = 1.82), colon diseases (OR = 1.31), and thyroid disorders (OR = 1.8). This study provides an update on the recent prevalence of obesity in Saudi Arabia. It also shows the variation in prevalence rates between different regions, which might be explored further. Although obesity shows a decreasing trend, almost one-quarter of this study sample were obese. Obesity is currently associated with many health conditions that can affect the individuals’ quality of life, impose stress on the healthcare system and impose an economic burden on the country. This evidence highlights the need for action to focus more on obesity in Saudi Arabia.

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Exploring Safety Aspects in Dental School Clinics Including Droplet Infection Prevention

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.4941 ◽

2020 ◽

Vol 8 (E) ◽

pp. 509-515

Author(s):

Asmaa Abdelnaby ◽

Laila Mahmoud Kamel ◽

Jylan Elguindy ◽

Reham Yousri Elamir ◽

Eman Elfar

Keyword(s):

Health Care ◽

Patient Safety ◽

Infection Control ◽

Dental Health ◽

Survey Study ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Safety Practices ◽

Preparedness Plan ◽

Dental Schools

BACKGROUND: Health-care safety focuses on improving patient’s and worker’s safety in a safe working clinics’ environment and prevent infection transmission including droplet infections as seasonal influenza and novel coronavirus (COVID-19). Dental health-care personnel (DHCP) are the target of safety measures and are themselves responsible for elimination of preventable harm. Dental schools are expected to demonstrate the model for quality safe care. AIM: This study aims to achieve high-quality safe dental care at dental clinics, Faculty of Dentistry, Cairo University. METHODS: A cross-sectional survey study was conducted at two Dental Outpatient Clinics, Cairo University. Disk review of policies, observation checklists for practices and awareness questionnaires of DHCP were used. RESULTS: DHCP showed good awareness for most of infection control (IC) and X-ray safety items. However, there are no policies or procedures to control droplet infections in the clinics. The clinics were closed in the current COVID-19 pandemic. There were poor patient safety practices, hand hygiene compliance, and personal protective equipment (PPE) use except for protecting clothes and disposable gloves. Students showed better compliance for patient safety guidelines. Other safety policies were poorly communicated. CONCLUSION: There should be preparedness plan to deal with any droplet infection outbreak, epidemic or pandemic as COVID-19 in all dental settings. There is a need to initiate dental safety unit in dental schools to implement, communicate, train, and supervise all dental safety practices including infection control.

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Health Literacy is Associated with Health Behaviors in Students from Vocational Education and Training Schools: A Danish Population-Based Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17020671 ◽

2020 ◽

Vol 17 (2) ◽

pp. 671 ◽

Cited By ~ 3

Author(s):

Charlotte Demant Klinker ◽

Anna Aaby ◽

Lene Winther Ringgaard ◽

Anneke Vang Hjort ◽

Melanie Hawkins ◽

...

Keyword(s):

Health Literacy ◽

Health Behavior ◽

Vocational Education ◽

Economic Status ◽

Education And Training ◽

Vocational Education And Training ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Scale Scores ◽

And Training

Health literacy has been identified as an important and changeable intermediary determinant of health equity. Vocational education and training (VET) schools are a relevant setting for health behavior interventions seeking to diminish health inequities because many VET students come from low socio-economic status backgrounds. This study examines VET students’ health literacy and its association with health behavior based on a cross-sectional survey among 6119 students from 58 VET schools in Denmark in 2019. Two scales from the Health Literacy Questionnaire was used to assess domains of health literacy. Data were analyzed using Anova and logistic regression. The study population consisted of 43.4% female, and mean age was 24.2 years (range 15.8–64.0). The health literacy domain ‘Actively managing my health’ mean was 2.51, SD 0.66, and ‘Appraisal of health information’ mean was 2.37, SD 0.65. For both domains, being female, older age, attending the VET educational program Care-health-pedagogy, and higher self-rated health were associated with higher scale scores. In the adjusted analyses, lower scale scores were associated with less frequent breakfast, daily smoking, high-risk alcohol behavior and moderate-to-low physical activity. Our results show that low health literacy is associated with unhealthy behaviors in this population. Our results support and inform health literacy research and practice in educational institutions and services.

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Essential Medicines at the National Level: The Global Asthma Network’s Essential Asthma Medicines Survey 2014

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16040605 ◽

2019 ◽

Vol 16 (4) ◽

pp. 605 ◽

Cited By ~ 4

Author(s):

Karen Bissell ◽

Philippa Ellwood ◽

Eamon Ellwood ◽

Chen-Yuan Chiang ◽

Guy Marks ◽

...

Keyword(s):

Inhaled Corticosteroids ◽

Communicable Disease ◽

Action Plan ◽

National Level ◽

Essential Medicines ◽

World Health ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Middle Income ◽

Poor Access

Patients with asthma need uninterrupted supplies of affordable, quality-assured essential medicines. However, access in many low- and middle-income countries (LMICs) is limited. The World Health Organization (WHO) Non-Communicable Disease (NCD) Global Action Plan 2013–2020 sets an 80% target for essential NCD medicines’ availability. Poor access is partly due to medicines not being included on the national Essential Medicines Lists (EML) and/or National Reimbursement Lists (NRL) which guide the provision of free/subsidised medicines. We aimed to determine how many countries have essential asthma medicines on their EML and NRL, which essential asthma medicines, and whether surveys might monitor progress. A cross-sectional survey in 2013–2015 of Global Asthma Network principal investigators generated 111/120 (93%) responses—41 high-income countries and territories (HICs); 70 LMICs. Patients in HICs with NRL are best served (91% HICs included ICS (inhaled corticosteroids) and salbutamol). Patients in the 24 (34%) LMICs with no NRL and the 14 (30%) LMICs with an NRL, however no ICS are likely to have very poor access to affordable, quality-assured ICS. Many LMICs do not have essential asthma medicines on their EML or NRL. Technical guidance and advocacy for policy change is required. Improving access to these medicines will improve the health system’s capacity to address NCDs.

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