Implementing an antimicrobial stewardship programme

2016 ◽  
Author(s):  
Patrick Doyle
Keyword(s):  
Antimicrobial Stewardship ◽  
Successful Implementation ◽  
Management Support ◽  
Governance Framework ◽  
The Right ◽  
The Impact ◽  
Programme Planning

Implementing an antimicrobial stewardship programme in an institution can be challenging. This chapter describes the process of the implementation of the programme—planning, doing, studying, acting. Planning involves understanding the institution’s environment, developing a case and gaining clinical and management support, creating a governance framework, and assembling the the right team. The nature and composition of the antimicrobial stewardship team is explored in detail. Doings means getting started—the importance of ‘quick wins’ that can be achieved to ensure acceptance and the importance of communication and a vision are covered. Studying means measuring and assessing the impact of the programme. Acting involves modifying and expanding the programme. Obstacles to successful implementation are discussed. Finally the chapter touches on the importance of entrenching the gains of the programme.

scholarly journals Antimicrobial Stewardship and Its Impact on the Changing Epidemiology of Polymyxin Use in a South Indian Healthcare Setting

Antibiotics ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 470
Author(s):  
Dipu T. Sathyapalan ◽  
Jini James ◽  
Sangita Sudhir ◽  
Vrinda Nampoothiri ◽  
Praveena N. Bhaskaran ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Tertiary Care ◽  
Successful Implementation ◽  
Loading Dose ◽  
Antimicrobial Stewardship Program ◽  
Entire Study ◽  
Stewardship Program ◽  
South Indian ◽  
Implementation Period ◽  
The Right

Polymyxins being last resort drugs to treat infections triggered by multidrug-resistant pathogens necessitates the implementation of antimicrobial stewardship program (ASP) initiatives to support its rational prescription across healthcare settings. Our study aims to describe the change in the epidemiology of polymyxins and patient outcomes following the implementation of ASP at our institution. The antimicrobial stewardship program initiated in February 2016 at our 1300 bed tertiary care center involved post-prescriptive audits tracking polymyxin consumption and evaluating prescription appropriateness in terms of the right indication, right frequency, right drug, right duration of therapy and administration of the right loading dose (LD) and maintenance dose (MD). Among the 2442 polymyxin prescriptions tracked over the entire study period ranging from February 2016 to January 2020, the number of prescriptions dropped from 772 prescriptions in the pre-implementation period to an average of 417 per year during the post-implementation period, recording a 45% reduction. The quarterly patient survival rates had a significant positive correlation with the quarterly prescription appropriateness rates (r = 0.4774, p = 0.02), right loading dose (r = 0.5228, p = 0.015) and right duration (r = 0.4361, p = 0.04). Our study on the epidemiology of polymyxin use demonstrated favorable effects on the appropriateness of prescriptions and mortality benefits after successful implementation of antimicrobial stewardship in a real-world setting.

scholarly journals The right to smoke and the right to smoke-free surroundings: international comparison of smoke-free psychiatric clinic implementation experiences

BJPsych Open ◽  
2021 ◽  
Vol 7 (3) ◽  
Author(s):  
Tove Freiburghaus ◽  
Rie Raffing ◽  
Montse Ballbè ◽  
Antoni Gual ◽  
Hanne Tönnesen
Keyword(s):  
Qualitative Methodology ◽  
Smoking Ban ◽  
Psychiatric Clinic ◽  
Successful Implementation ◽  
Management Support ◽  
Staff Education ◽  
Structured Interviews ◽  
Implementation Processes ◽  
Compulsory Care ◽  
The Right

Background In Scandinavia, people with a severe mental disorder have a reduced life expectancy of 15–20 years compared with the general public. Smoking is a major contributor, and smoke-free policies are increasingly adopted in psychiatric clinics around the world. We compared potential facilitators and barriers among staff and management, for the implementation of smoke-free psychiatric clinics. Aims To investigate the attitudes and experiences regarding smoke-free policies among managers and staff involved in the implementation processes of smoke-free psychiatric clinics at hospitals in Malmö (Sweden) and Barcelona (Spain). Method We used a qualitative methodology, with 15 semi-structured interviews. The interviews were conducted with each participant individually, and were subsequently transcribed. The data were analysed with systematic text condensation. Results There were notable differences in how the smoke-free policies were carried out and experienced, and attitudes regarding the policy changes differed in the two settings. Key differences were the views on the right to smoke in compulsory care and to stay in smoke-free surroundings supported by smoking cessation intervention; the prioritisation of staff facilitation of smoking breaks; and views on smoking and smoke-free psychiatry. In contrast, participants agreed on the importance of staff education and management support. A smoking ban by law and belonging to a network of smoke-free hospitals were also relevant. Conclusions Staff education, and support from staff and management for the patients’ right to stay in smoke-free surroundings, facilitated successful implementation of smoke-free policies in the psychiatric clinics, whereas supporting the right to smoke was a barrier.

scholarly journals Achieving long-term modularization benefits: A small- and medium-sized enterprise study

2018 ◽  
Vol 27 (1) ◽  
pp. 14-27
Author(s):  
Niels Henrik Mortensen ◽  
Christian Alexander Bertram ◽  
Rasmus Lundgaard
Keyword(s):  
Goal Setting ◽  
Internal Communication ◽  
Successful Implementation ◽  
Management Support ◽  
Qualitative And Quantitative ◽  
New Development ◽  
Development Processes ◽  
Research Gap ◽  
The Right

Long-term commonalities and experiences with modularization in comparable small- and medium-sized enterprises have been identified as a research gap. This article contributes by describing a unique collection of experiences from companies that received a similar introduction to the same core modularization topics through a series of introductory initiatives. This shared introduction makes the projects and processes of the companies comparable. The study reveals three main aspects of achieving significant long-term benefits from modularization initiatives: the company must (1) aim big and be willing to change its foundation accordingly, (2) draw on the right positional strength and have broad organizational inputs, and (3) properly coordinate work and then actively seek to preserve the focus and results over a long period of time. Interviews were conducted with representatives from 12 of these companies. Qualitative and quantitative data obtained from the interviews were used to draw parallels between the definition, execution, and impact of modularization. The stated results and project circumstances show commonalities for the successful implementation of modularization. They indicate which actions lead to the desired changes and secure the results persistently. The participants have achieved various results, such as strategic changes, new architectures, fewer variants, higher product earnings, and new development processes. Some have also introduced maintenance plans to secure the results, such as establishing configurators, performing weekly analyses, recruiting dedicated personnel, and so on. The interviews revealed several influencing factors, such as management support, internal communication, organizational drive, proper facilitation, and prioritized project management. They also indicated that significantly more improvement can be achieved with proper goal setting and commitment to specific goals. These are the factors that can help future small- and medium-sized enterprises in the proper incorporation of modularization and in maximizing their exploitation of modularization theory.

scholarly journals Mental health nurses experience of the introduction and practice of the Safewards model: a qualitative descriptive study

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Heather Lee ◽  
Owen Doody ◽  
Therese Hennessy
Keyword(s):  
Mental Health ◽  
Patient Experience ◽  
Nursing Practice ◽  
Future Research ◽  
Successful Implementation ◽  
Mental Health Nurses ◽  
Training And Education ◽  
Qualitative Descriptive ◽  
The Right ◽  
The Impact

Abstract Background A lack of safety experienced by patients and staff in acute psychiatric units is a major concern and containment methods used to manage conflict have the potential to cause harm and upset to both staff and patients. To ensure safety for all, it is highly desirable to reduce levels of conflict and containment and the Safewards model is an evidence-based model aimed at reducing conflict and containment rates by improving nurse-patient relationships and safety. Methods The aim of this study was to explore mental health nurses’ experience of the introduction and practice of three Safewards interventions; reassurance, soft words and discharge messages. A qualitative descriptive research design utilising a purposive sample (n = 21) of registered psychiatric nurses (n = 16) and managers (n = 5) in an acute psychiatric unit in Ireland. Following a 12-week implementation of Safewards, three focus groups were conducted, two with nursing staff and one with nurse managers. Data were analysed using Braun and Clarke thematic analysis framework which supported the identification of four themes: introducing Safewards, challenges of Safewards, impact of Safewards and working towards success. Results The findings indicate that the process of implementation was inadequate in the training and education of staff, and that poor support from management led to poor staff adherence and acceptance of the Safewards interventions. The reported impact of Safewards on nursing practice and patient experience were mixed. Overall, engagement and implementation under the right conditions are essential for success and while some participants perceived that the interventions already existed in practice, participants agreed Safewards enhanced their communication skills and relationships with patients. Conclusion The implementation of Safewards requires effective leadership and support from management, mandatory training for all staff, and the involvement of staff and patients during implementation. Future research should focus on the training and education required for successful implementation of Safewards and explore the impact of Safewards on nursing practice and patient experience.

scholarly journals Antimicrobial Stewardship Program Implementation in a Saudi Medical City: An Exploratory Case Study

Antibiotics ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 280
Author(s):  
Saleh Alghamdi ◽  
Ilhem Berrou ◽  
Eshtyag Bajnaid ◽  
Zoe Aslanpour ◽  
Abdul Haseeb ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Program Implementation ◽  
Multi Drug Resistance ◽  
Successful Implementation ◽  
Management Support ◽  
Structured Interviews ◽  
Program Outcomes ◽  
Implementation Phase ◽  
Stewardship Program

Antimicrobial stewardship programs (ASPs) in hospitals have long been shown to improve antimicrobials’ use and reduce the rates of antimicrobial resistance. However, their implementation in hospitals, especially in developing countries such as Saudi Arabia, remains low. One of the main barriers to implementation is the lack of knowledge of how to implement them. This study aims to explore how an antimicrobial stewardship programme was implemented in a Saudi hospital, the challenges faced and how they were overcome, and the program outcomes. A key stakeholder case study design was used, involving in-depth semi-structured interviews with the core members of the ASP team and analysis of 35 ASP hospital documents. ASP implementation followed a top-down approach and involved an initial preparatory phase and an implementation phase, requiring substantial infectious diseases and clinical pharmacy input throughout. Top management support was key to the successful implementation. ASP implementation reduced rates of multi-drug resistance and prescription of broad-spectrum antimicrobials. The implementation of ASPs in hospital is administrator rather than clinician driven. Outsourcing expertise and resources may help hospitals address the initial implementation challenges.

PECULIARITIES IN VISUAL FUNCTIONS AND THEIR RESTORATION IN TEENAGERS WITH EMMETROPIC REFRACTION AFTER WORK ON COMPUTERS AND THE METHOD OF ITS REDUCTION

2017 ◽  
Vol 27 (79) ◽  
pp. 25-29
Author(s):  
Stepan Vadzuk ◽  
Nataliia Ulianytska ◽  
Svitlana Indyka ◽  
Olga Andriychuk ◽  
Olena Yakobson
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Teaching And Learning ◽  
Computer Work ◽  
Breath Holding ◽  
Successful Implementation ◽  
Visual Functions ◽  
Sensitivity Change ◽  
The Right ◽  
The Impact

Modern IT penetration leads to the sharing with usage of information devices, especially PCs, in teaching and learning process. Nowadays, according to the specialists’ research, in Ukraine above 9,5 million people are PC users (in fact, one in five people), but half of them is children and teenagers. As a result the changes in functional activity of different organs and systems are produced, but work with video-display terminals exerts the most influence on visual analyzer (Cochina 2009, Kovtun 2008). Goal of research: to study the visual acuity and contrast sensitivity in senior pupils while working at the computer monitor, and when disorders are determined to offer their effective correction. Methods and materials: Sixty healthy senior pupils (120 eyes) with emmetropic refraction were examined. The visual acuity and contrast sensitivity were investigated by special computer techniques. At the first stage the effect of one-hour uninterrupted computer work on visual functions was studied. Their state after a fifteen-minute passive rest was determined at the second stage. The author’s program “Eyesight Preservation and Restoration” that includes special exercises for eyes, upper limb girdle and neck with the elements of breath-holding, followed by the determination of the parameters in question was used at the third stage. Results of the research: We have found decrease in the visual acuity by 7.4% after one-hour constant visual strain on the computer monitor. Conspicuous is the fact that doing the restoration exercises for fifteen minutes after one-hour visual strain increased the visual acuity by 7.2%. It is worth pointing out the contrast sensitivity increases to 36,1 ± 1,42% and 36,08 ± 1,65% respectively in the right eye and in the left eye after one-hour visual workload. This indicates the contrast sensitivity decrease in the eyes and the reduction of successful implementation of visual work under the changes in brightness. Conclusions: Thus, the indices of the visual functions, such as the visual acuity and contrast sensitivity change under the impact of the work on the PC, but the fifteen-minute set of the restoration exercises brings them closer to the baseline.

scholarly journals Factors Contributing to the Successful Implementation of Management Innovations

2018 ◽  
Vol 15 (3-4) ◽  
pp. 75-106
Author(s):  
Zdravko Zekić ◽  
Mirjana Grčić Fabić ◽  
Luka Samaržija
Keyword(s):  
Organizational Factors ◽  
Successful Implementation ◽  
Management Innovation ◽  
Management Support ◽  
Implementation Climate ◽  
Innovation Research ◽  
Management Concepts ◽  
Efficiency And Effectiveness ◽  
Distinctive Type ◽  
The Impact

The concept of management innovation as distinctive type of non-technological innovations is still in the early days of conceptual formation and confirmation. This paper aims to investigate the concept of management innovations in public sector organizations with an emphasis on identifying the impact of organizational factors on the successful implementation of management innovations. The aim of implementation of new management concepts and methods is to increase efficiency and effectiveness of public services. A research was conducted on a sample of local self-government units in Croatia using empirical methods. The obtained results confirm the set conceptual determinants of the management innovation term, as manifested through the influence of selected organizational factors. Accordingly, absorptive capacity and top management support, with the combined effects of implementation climate and innovation-values fit, have been identified as key factors to achieving successful implementation of management innovations. On the other hand, availability of significant financial resources was not found to be a significant factor for the effective implementation of this type of innovation. Research results suggest theoretical and practical implications for strengthening the effectiveness of local self-government.

Emotional Reactivity to Visual Content as Revealed by ERP Component Clustering

2015 ◽  
Vol 29 (4) ◽  
pp. 135-146 ◽  
Author(s):  
Miroslaw Wyczesany ◽  
Szczepan J. Grzybowski ◽  
Jan Kaiser
Keyword(s):  
Emotional Reactivity ◽  
Brain Activity ◽  
Affective State ◽  
Occipital Lobe ◽  
Stimulus Onset ◽  
Emotional States ◽  
Neural Basis ◽  
Temporoparietal Junction ◽  
The Right ◽  
The Impact

Abstract. In the study, the neural basis of emotional reactivity was investigated. Reactivity was operationalized as the impact of emotional pictures on the self-reported ongoing affective state. It was used to divide the subjects into high- and low-responders groups. Independent sources of brain activity were identified, localized with the DIPFIT method, and clustered across subjects to analyse the visual evoked potentials to affective pictures. Four of the identified clusters revealed effects of reactivity. The earliest two started about 120 ms from the stimulus onset and were located in the occipital lobe and the right temporoparietal junction. Another two with a latency of 200 ms were found in the orbitofrontal and the right dorsolateral cortices. Additionally, differences in pre-stimulus alpha level over the visual cortex were observed between the groups. The attentional modulation of perceptual processes is proposed as an early source of emotional reactivity, which forms an automatic mechanism of affective control. The role of top-down processes in affective appraisal and, finally, the experience of ongoing emotional states is also discussed.

Technology and Hospital Information System: A Case of Implementation of Electronic Clinical Records in Hospital Maternity Irene Neto in Lubango, Angola

2019 ◽  
Vol 10 (11) ◽  
pp. 1131-1135
Author(s):  
Tomas Hambili Paulo Sanjuluca ◽  
◽  
Ricardo Correia ◽  
Anabela Antunes de Almeida ◽  
Ana Gloria Diaz Martinez ◽  
...  
Keyword(s):  
Maternity Hospital ◽  
Management Support ◽  
Retrospective Case ◽  
System A ◽  
Clinical Records ◽  
Retrospective Case Study ◽  
The Impact ◽  
And Child Health

Introduction: In order to have a good assessment of the quality of maternal and child health care, it is essential that there is up-to-date and reliable information. Objective: To evaluate the impact of the implementation of a computerized database of clinical processes in the admission, archive and medical statistics section, of Maternity hospital Irene Neto/Lubango-Angola. Methodology: A descriptive study with a quantitative and qualitative approach to carry out a retrospective case study deliveries and newborns, records from 2014 to 2017. Final considerations: The implementation of this project may contribute to the improvement of clinical management support management of the hospital as well as facilitating access to information for research and scientific production.

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