scholarly journals Knowledge, Attitudes, and Perceptions about Antibiotic Stewardship Programs among Neonatology Trainees

2021 ◽  
Author(s):  
Ibukunoluwa C. Kalu ◽  
Sagori Mukhopadhyay ◽  
Dmitry Dukhovny ◽  
Rebecca Young ◽  
Judith A. Guzman-Cottrill
Keyword(s):  
United States ◽  
Small Group ◽  
Antibiotic Stewardship ◽  
Neonatal Intensive Care ◽  
The United States ◽  
Audit And Feedback ◽  
Neonatal Meningitis ◽  
Stewardship Program ◽  
Medical Education Program ◽  
Attitudes And Perceptions

Objective Antibiotic stewardship should be an essential component of neonatology training as neonatal intensive care units (NICU) have unique stewardship needs. Our aim was to assess neonatology fellowship trainees' knowledge, attitudes, and perceptions about antibiotic stewardship to inform sustainable curriculum development. Study Design We distributed an electronic survey to neonatology fellows in the United States over 4 months (January–April 2018) via Accreditation Council for Graduate Medical Education program directors. Results Of 99 programs in the United States with an estimated 700 fellows, 159 (23%) fellows from 52 training programs (53%) responded to the survey and 139 (87%) provided analyzed responses. Majority of respondents were training in southern (59; 42%) and northeastern (43; 31%) regions and were equally spread across all 3 years of training. One hundred (72%) respondents reported an antibiotic stewardship program (ASP) in their institution. While 86% (120/139) were able to identify the components of an ASP, 59% (82/139) either did not or were unsure if they had received antibiotic stewardship training during fellowship.Furthermore, while answering case studies, 124 (89%) respondents identified the optimal antibiotic for methicillin susceptible Staphylococcus aureus (MSSA) infection and 69 (50%) respondents chose appropriate empiric antibiotics for neonatal meningitis. Notably, fellowship training year was not significantly related to the proportion of incorrect knowledge responses (p = 0.40). Most survey respondents (81; 59%) identified small group sessions as the most useful teaching format, while others chose audit and feedback of individual prescribing behavior (52; 38%) and didactic lectures (52; 38%). Finally, ninety-five (69%) respondents preferred trainee-led ASP interventions targeting focal areas such as antifungal and surgical prophylaxis. Conclusion Antibiotic stewardship is a critical part of neonatology training. Neonatology fellows report variation in access to ASP during their training. Fellows prefer dedicated trainee-led interventions and stewardship curriculum taught within small group settings to promote targeted NICU ASP. Key Points

scholarly journals 1128. Knowledge, Attitudes and Perceptions about Antibiotic Stewardship (AS) Programs among Neonatology Trainees

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S401-S401
Author(s):  
Ibukunoluwa C Akinboyo ◽  
Sagori Mukhopadhyay ◽  
Dmitry Dukhovny ◽  
Rebecca R Young ◽  
Karen Puopolo ◽  
...  
Keyword(s):  
Small Group ◽  
Antibiotic Stewardship ◽  
The United States ◽  
Audit And Feedback ◽  
Fundamental Aspect ◽  
Neonatal Meningitis ◽  
Resistant Bacteria ◽  
Equal Proportion ◽  
Attitudes And Perceptions ◽  
Group Sessions

Abstract Background Antibiotic stewardship (AS) is a fundamental aspect of medical training. Neonatal Intensive Care Units (NICU) often have unique stewardship needs as they are ideal settings for the emergence and spread of drug-resistant bacteria. Assessing neonatology fellowship trainees’ knowledge and perceptions will highlight deficits in AS education and inform future curriculum development. Methods Prospective electronic survey study, distributed by Accreditation Council for Graduate Medical Education (ACGME) program directors to neonatology fellows in the United States over 4 months (January to April 2018). The objective was to assess neonatology fellows’ knowledge, attitudes and perceptions about AS to inform sustainable NICU-specific AS programs. Results Of 99 programs and 700 fellows, 159 respondents (23%) from 40 neonatology training programs (40%) responded to the survey and 139 (87%) provided complete responses. Respondents were equally spread across all 3 years of training Seventy-two percent confirmed an institutional AS program existed, yet, only 33% were able to identify the components of AS programs and 66% either did not or were unsure if they had received AS training during fellowship. Furthermore, only 51% identified the appropriate empiric antibiotic for neonatal meningitis and 12% identified optimal methicillin-susceptible Staphylococcus aureus (MSSA) treatment while answering clinical case study questions. Notably, fellowship training year was not significantly related to the proportion of incorrect responses (P = 0.40). Small group sessions were identified as the best teaching format (35%). This was followed by audit and feedback of individual prescribing behavior and didactic lectures which had an equal proportion of respondents (22%). Seventy-eight percent of respondents preferred a trainee-led AS program targeting necrotizing enterocolitis, antifungal prophylaxis and appropriate surgical prophylaxis. Conclusion Antibiotic stewardship is a critical part of physician training. While most institutions have a stewardship program, a dedicated curriculum incorporating small group sessions and didactics may be beneficial for educating neonatology trainees. Disclosures All authors: No reported disclosures

scholarly journals Clinical impact of pharmacist-led antibiotic stewardship programs in outpatient settings in the United States: A scoping review

2021 ◽  
Author(s):  
James St. Louis ◽  
Arinze Nkemdirim Okere
Keyword(s):  
United States ◽  
Usual Care ◽  
Antibiotic Stewardship ◽  
The United States ◽  
Controlled Trials ◽  
Antibiotic Prescribing ◽  
Successful Implementation ◽  
Pharmacist Interventions ◽  
Outpatient Settings ◽  
The Impact

Abstract Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose To provide an overview of the impact of pharmacist interventions on antibiotic prescribing and the resultant clinical outcomes in an outpatient antibiotic stewardship program (ASP) in the United States. Methods Reports on studies of pharmacist-led ASP interventions implemented in US outpatient settings published from January 2000 to November 2020 and indexed in PubMed or Google Scholar were included. Additionally, studies documented at the ClinicalTrials.gov website were evaluated. Study selection was based on predetermined inclusion criteria; only randomized controlled trials, observational studies, nonrandomized controlled trials, and case-control studies conducted in outpatient settings in the United States were included. The primary outcome was the observed differences in antibiotic prescribing or clinical benefits between pharmacist-led ASP interventions and usual care. Results Of the 196 studies retrieved for full-text review, a cumulative total of 15 studies were included for final evaluation. Upon analysis, we observed that there was no consistent methodology in the implementation of ASPs and, in most cases, the outcome of interest varied. Nonetheless, there was a trend toward improvement in antibiotic prescribing with pharmacist interventions in ASPs compared with that under usual care (P < 0.05). However, the results of these studies are not easily generalizable. Conclusion Our findings suggest a need for a consistent approach for the practical application of outpatient pharmacist-led ASPs. Managed care organizations could play a significant role in ensuring the successful implementation of pharmacist-led ASPs in outpatient settings.

Limitation of Private Attending Pediatricians' Neonatal Intensive Care Privileges in Level III Institutions Throughout the United States

PEDIATRICS ◽  
1994 ◽  
Vol 94 (2) ◽  
pp. 190-193
Author(s):  
Rita G. Harper ◽  
Concepcion G. Sia ◽  
Regina Spinazzola ◽  
Raul A. Wapnir ◽  
Shahnaz Orner ◽  
...  
Keyword(s):  
United States ◽  
Intensive Care ◽  
Health Care Providers ◽  
Curriculum Design ◽  
Neonatal Intensive Care ◽  
District Of Columbia ◽  
The United States ◽  
Geographic Region ◽  
Neonatal Intensive Care Units ◽  
Care Providers

Objective. To determine the privileges of Private Attending Pediatricians (PAP) in caring for newborns requiring intensive (ITC), intermediate (IMC), or continuing (CC) care in Level III neonatal intensive care units (NICUs) throughout the United States. Design. A two-page mail questionnaire was sent to 429 Level III NICUs to obtain the statement best describing the PAPs' privileges, the number of PAP, and some of the PAPs' functions. Level III NICUs were classified by geographic region as Eastern, Central, or Western United States. Results. Responses were received from 301 NICUs (70%) representing 48 states, the District of Columbia, and >9000 PAP. Twenty-two institutions had no PAP. In the remaining 279 institutions, 96% (267/279) had restricted the PAPs' privileges partially or completely. In 32% (88/279), the PAP were not allowed to render any type of NICU care. In 18% (51/279) of the institutions, the PAP were allowed to render CC only. In 27% (76/279) of the institutions, the PAP were allowed to render IMC and CC only. Limitation of PAPs' privileges were reported in all geographic areas in the U.S., were more pronounced in the Eastern than the Central or Western sections of the country, and were noted in institutions with small (≤10) as well as large (≥60) numbers of PAP. Limitation of PAPs' privileges was determined by the PAP him/herself in many institutions. Proficiency in resuscitation was considered to be a needed skill. Communication with parents of an infant under the care of a neonatologist was encouraged. Conclusions. The PAPs' privileges were limited partially or completely in most Level III NICUs. Knowledge of this restricted role impacts significantly on curriculum design for pediatric house officers, number and type of health care providers required for Level III NICUs and future house officer's career choices.

Variation in Performance of Neonatal Intensive Care Units in the United States

2017 ◽  
Vol 171 (3) ◽  
pp. e164396 ◽  
Author(s):  
Jeffrey D. Horbar ◽  
Erika M. Edwards ◽  
Lucy T. Greenberg ◽  
Kate A. Morrow ◽  
Roger F. Soll ◽  
...  
Keyword(s):  
United States ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
The United States ◽  
Neonatal Intensive Care Units

France and the United States View Each Other From Across the Atlantic a report of two surveys

1982 ◽  
Vol 4 (2) ◽  
pp. 275-279
Keyword(s):  
United States ◽  
The United States ◽  
The Past ◽  
The People ◽  
Attitudes And Perceptions ◽  
Trend Data

The results of the surveys conducted in France and the United States reveal not only current attitudes and perceptions of the people, but more importantly, on those questions where trend data are available, the changes in attitudes which have occurred over the past six years can be measured.

The 1913 Armory Show, New York City

2018 ◽  
Author(s):  
Laura Braden
Keyword(s):  
United States ◽  
New York ◽  
New York City ◽  
Small Group ◽  
York City ◽  
Modern Art ◽  
The United States ◽  
International Exhibition ◽  
American Artists ◽  
Armory Show

The 1913 Armory Show was the first comprehensive exhibition of modern art to take place in the United States and served as America’s introduction to modernism in the visual arts. Formally titled the International Exhibition of Modern Art—but informally designated the "Armory Show," given its location at the 69th Infantry Regiment Armory in New York City—the exhibition was organized by the Association of American Painters and Sculptors (AAPS), a small group of American artists, with the goal of offering a survey of modern art from Impressionism to Cubism and to spur the establishment of modern art in the United States. The exhibition ran for four weeks (February 17–March 15, 1913) and offered more than 1,300 works by 308 artists who hailed from twenty-five nations (though American artists composed more than half of this total).

Shiva’s Babies

2019 ◽  
pp. 124-141
Author(s):  
Swasti Bhattacharyya
Keyword(s):  
United States ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
High Risk ◽  
Neonatal Intensive Care ◽  
Newborn Infants ◽  
Nationwide Survey ◽  
The United States ◽  
Cultural Humility ◽  
Religious Perspectives

Discussing religious views from within any tradition is challenging because they are not monolithic. However, it is worth exploring religious perspectives because they are often the foundation, whether conscious or not, of the reasoning underlying people’s decisions. Following a brief discussion on the importance of cultural humility and understanding the worldview of patients, the author focuses on Hindu perspectives regarding the care of infants in the neonatal intensive care unit. Along with applying six elements of Hindu thought (underlying unity of all life, multivalent nature of Hindu traditions, dharma, emphasis on societal good, karma, and ahimsa), the author incorporates perspectives of Hindu adults, living in the United States, who responded to a nationwide survey regarding the care of high-risk newborn infants in the hospital.

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