Implementation status of antimicrobial stewardship programs in hospitals: A quantitative analysis study in Ho Chi Minh city, Vietnam

MedPharmRes ◽  
2020 ◽  
Vol 4 (2) ◽  
pp. 34-39
Author(s):  
Thi-Hai-Yen Nguyen ◽  
Truong Van Dat ◽  
Phuong-Thao Huynh ◽  
Chi-Thuong Tang ◽  
Vinh-Chau Van Nguyen ◽  
...  

Vietnam has one of the highest multi drug resistance in Asia. Although, despite many efforts to implement the Antimicrobial Stewardship Programs (the ASP) since 2016, studies that on the implementation policy are very lacking of this program are limited. For that reason, we conducted this cross-sectional study to analyze the viewpoint of health workers (HWs) on the implementation of the ASP at some hospitals in Ho Chi Minh City (HCMC). An assessment of 234 HWs showed that the implementation of the ASP in HCMC hospitals was above average (62.7/100.0). A barrier to the implementation consisted of the deficiency in finances, guidelines for diagnosis, and specific interventions for some common infections, such as distributing current antibiogram and monitoring rate of Clostridioides difficile infections. These were the widely recognized problems in initially implementing the ASP. Although most HWs are aware of the importance of implementing the ASP (79.1%), the specific assessment has not been recorded clearly due to the numerous neutral responses. Despite the support of the leadership, the implementation still faces many difficulties and limitations, especially in 3rd and 4th class hospitals. Besides, there was a lack of wide dissemination of information on the ASP at each unit. To generalize the status of the ASP implementation, researchers should conduct qualitative and quantitative studies with a larger scale.

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248692
Author(s):  
Alexandru-Cristian Tuca ◽  
Johanna Münch ◽  
David L. B. Schwappach ◽  
Andrea Borenich ◽  
Chiara Banfi ◽  
...  

Introduction Morbidity and mortality conferences (M&MCs) are an instrument for learning from past complications, unexpected follow-ups and deaths in hospitals and are important for improving patient safety. However, there are currently no quantitative data on the implementation of M&MCs in Austria. The aim of the study was to determine the status quo of the M&MCs in Austria. Materials and methods A national cross-sectional study was conducted by means of a survey of 982 chief physicians of surgical disciplines, internal medicine, anesthesiology, intensive care, gynecology/obstetrics and pediatrics. The questionnaire focused on overall goals, structure and procedures of hospital M&MCs. Results Of the 982 contacted chief physicians, 314 (32.0%) completed the survey. Almost two thirds of the respondents, i.e. 203 (64.7%), had already implemented M&MCs. Of the 111 chief physicians who had not yet introduced M&MCs, 62 (55.9%) were interested in introducing such conferences in the future. Of the 203 respondents that had implemented M&MCs, 100 stated that their M&MC could be improved. They reported issues with "shame and blame" culture, hierarchical structures, too little knowledge about the capability of M&MC and, in particular, time constraints. Overall, the participating chief physicians showed that they are striving to improve their existing M&MCs. Discussion/Conclusion While we found a relatively high number of already implemented M&MCs we also identified a large heterogeneity in the format of the M&MCs. A highly structured M&MC including guidelines, checklists or templates does not only considerably improve its outcome but can also alleviate the main limiting factor which is the lack of time.


2021 ◽  
Author(s):  
Christina Kashililika ◽  
Fabiola Vincent Moshi

Abstract BackgroundMaternal and Perinatal Deaths Review and Surveillance (MPDSR) system when used effectively has the power to bring into reality, a revolutionary victory in the fight against maternal and perinatal mortality from avoidable causes. This study aimed at determining the status of implementation of the system among health facilities in rural settings of Tanzania.MethodThis study was conducted among 38 health facilities from three districts of Morogoro region, Tanzania from April 27, 2020 to May 29, 2020. Quantitative data was collected through document review for MPDSR implementation status. The outcome was determined by using special scoring sheet with a total 30 points. Facilities that scored 10 points or above were considered to have satisfactory status of MPDSR implementation while the facilities that scored below 10 points were considered to have unsatisfactory status of MPDSR implementation. Bivariate logistic regression analyses were used to determine the predictors of implementation status among health facilities.ResultsMajority of health facilities 20(52.6%) had satisfactory MPDSR implementation status. The predictors of MPDSR implementation in a facility were level of health facility [Hospital (AOR = 11.945 at 95% CI = 1.133 – 125.942, P = 0.039)] and ownership of the facility [Public (AOR = 0.133 at 95% CI = 0.019 – 0.920, P = 0.041)].ConclusionMPDSR implementation status among health facility is on average not satisfactory. More efforts are needed to raise the status of MPDSR implementation in the country so that the maximum benefit of MPDSR is obtained.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christina Jacob Kashililika ◽  
Fabiola Vincent Moshi

Abstract Background When used effectively, the Maternal and Perinatal Death Surveillance and Response (MPDSR) system can bring into reality a revolutionary victory in the fight against maternal and perinatal mortality from avoidable causes. This study aimed at determining the status of implementation of the system among health facilities in the Morogoro Region. Method This study was conducted among 38 health facilities from three districts of the Morogoro region, Tanzania, from April 27, 2020, to May 29, 2020. Quantitative data were collected through document review for MPDSR implementation status. The outcome was determined by using a unique scoring sheet with a total of 30 points. Facilities that scored less than 11 points were considered to be in the pre-implementation phase, those scored 11 to 17 were considered in the implementation phase, and those scored 18 to 30 were considered to be in the institutionalization phase. Results The majority 20(53 %) of health facilities were in the pre-implementation phase, only 15(40 %) of assessed health facilities were in the implementation phase, and few 3(8 %) of health facilities were in institutionalization phase. There was a strong evidence that MPDSR implementation was more advanced in urban compared to rural health facilities (Fisher’s test = 6.158, p = 0.049), hospitals compared to health centers (Fisher’s test =14.609, p <0.001) and private and faith-based organization than public facilities (Fisher’s test, 15.897 = p = 0.002). Conclusions The study revealed that health facilities in Morogoro Region have not adequately implemented the MPDSR system. The majority of health facilities in rural settings and owned by the government showed poor MPDSR implementation and hence called for immediate action to rectify the situation. Strengthen MPDSR implementation, health facilities should be encouraged to adhere to the available MPDSR guidelines in the process of death reviews. Transparent systems should also be established to ensure thorough tracking and follow-up of recommendations evolving from MPDSR reviews. Health facilities should also consider integrating MPDSR to other quality improvement teams to maximize its efficiency.


2020 ◽  
Vol 04 (03) ◽  
pp. 116-123
Author(s):  
Duc Thanh Nguyen ◽  
◽  
Xuan Luong Nguyen ◽  
Thanh Phung

Human resource for health plays a vital role in improving accessibility to services and quality of care. This is cross-sectional study, combining quantitative and qualitative aims to fulfill two objectives: (1) to describe the job motivation of doctors, and (2) to analyze some factors affecting the job motivation of doctors at Ho Chi Minh City Traditrional Medicine Instittue 2020. The research results show that the average job motivation proportion of doctors at Ho Chi Minh City Traditrional Medicine Institue is 81.8%, in which the "Satisfaction with the job", "Dedication to work" and "Commitment to organizations” are at 84.2%; 82.2% and 78.9% respectively. Some of the factors posstively influence job motivation including salary, additional income and other benefits; relationship with colleagues. Besides, some negative influencing factors include facilities and equipments; operating administration. Key words: doctors, health workers, job motivation.


2021 ◽  
Vol 1 (12) ◽  
pp. e0000083
Author(s):  
Pratik Khanal ◽  
Kiran Paudel ◽  
Navin Devkota ◽  
Minakshi Dahal ◽  
Shiva Raj Mishra ◽  
...  

Health workers involved in the COVID-19 response might be at risk of developing fear and psychological distress. The study aimed to identify factors associated with COVID-19 fear among health workers in Nepal during the early phase of the pandemic. A web-based survey was conducted in April-May 2020 among 475 health workers directly involved in COVID-19 management. The Fear Scale of COVID 19 (FCV-19S) was used to measure the status of fear. Multivariable logistic regression was performed to identify factors associated with COVID fear. The presence of COVID-19 fear was moderately correlated with anxiety and depression, and weakly correlated with insomnia. Nurses, health workers experiencing stigma, working in affected district, and presence of family members with chronic diseases were significantly associated with higher odds of developing COVID-19 fear. Based on the study findings, it is recommended to improve the work environment to reduce fear among health workers, employ stigma reduction interventions, and ensure personal and family support for those having family members with chronic diseases.


2020 ◽  
Vol 20 (2) ◽  
pp. 167-174
Author(s):  
Ilo Dicko ◽  
Yaya Ibrahim Coulibaly ◽  
Modibo Sangaré ◽  
Bismark Sarfo ◽  
Priscillia Awo Nortey

Background: Lymphatic filariasis (LF) is a parasitic disease that has been targeted for elimination through the Mass Drug Administration (MDA.) Although the MDA started in the Ankobra community in Ghana in 2000, LF prevalence as reported in 2014 was relatively high (4.5%). Non-compliance to the MDA has been associated with the persistent LF prevalence in endemic regions. Objective: This study determined the factors associated with the non-compliance to the MDA among patients living in the Ankobra community, Ghana. Methods: A cross-sectional study using a one-stage cluster sampling method was used to collect data between June and July, 2017 in Ankobra. Questionnaires were used to collect data from health workers, the MDA drug distributors and study participants in Ankobra. Data analysis was performed using STATA 14. Logistic regression was used to measure the degree of association between the dependent (non-compliance) and independent variables. Non-compliance rate was defined as the percentage of individuals who self-reported that they did not actually swallow the drugs provided during the MDA. Results: The MDA coverage and non-compliance rates were 73.5% (147/200) and 33.33% (49/147) respectively. The main reason for non-compliance was fear of drug adverse events (75.51%, 37/49). Thought of “not being susceptible to LF” was significantly associated with the non-compliance (aOR= 2.83, [CI= 1.15, 6.98]). Conclusion: Health education about the susceptibility of residents getting LF disease in endemic community must be intensified to improve compliance to MDA medication ingestion and thus meet the Global Elimination of Lymphatic Filariasis by 2020.


Author(s):  
Sofia Pappa ◽  
Joshua Barnett ◽  
Ines Berges ◽  
Nikolaos Sakkas

The burden of the COVID-19 pandemic on health systems and the physical and mental health of healthcare workers (HCWs) has been substantial. This cross-sectional study aims to assess the effects of COVID-19 on the psychological wellbeing of mental health workers who provide care to a vulnerable patient population that have been particularly affected during this crisis. A total of 387 HCWs from across a large urban mental health service completed a self-administered questionnaire consisting of socio-demographic, lifestyle and work-based information and validated psychometric scales. Depression and anxiety were measured using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7), respectively; sleep problems with the Athens Insomnia Scale (AIS); burnout with the Maslach Burnout Inventory (MBI); and resilience with the Resilience Scale-14 (RS-14). Multivariable logistic regression analysis was performed to determine potential mediating factors. Prevalence of burnout was notable, with 52% recording moderate/severe in Emotional Exhaustion, 19.5% moderate/severe in Depersonalisation, and 55.5% low/moderate Personal Accomplishment. Over half of all respondents (52%) experienced sleep problems; the presence of depressive symptoms was a significant predictor of insomnia. An increase in potentially harmful lifestyle changes, such as smoking, alcohol consumption and overeating was also observed. However, high Resilience was reported by 70% of the samples and the importance of this is highlighted. Female gender was associated with increased levels of depression and emotional exhaustion while those with a history of mental health conditions were most at risk of affective symptoms, insomnia, and burnout. Overall, our study revealed considerable levels of psychological distress and maladaptive coping strategies but also resilience and satisfaction with organizational support provided. Findings can inform tailored interventions in order to mitigate vulnerability and prevent long-term psychological sequelae.


Antibiotics ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 866
Author(s):  
Iltaf Hussain ◽  
Nisa Yousaf ◽  
Sana Haider ◽  
Pervisha Jalil ◽  
Muhammad Usman Saleem ◽  
...  

The irrational use of antimicrobials has enormously contributed to antimicrobial resistance (AMR) globally and especially in the developing world. To assess the knowledge and perception regarding AMR and antimicrobial stewardship (AMS), a descriptive cross-sectional study was carried out in university students enrolled in pharmacy, veterinary, and biology programs by using an online self-administered questionnaire. The Chi-square and Fisher exact tests (where applicable) were performed to assess the association of the demographics with the students’ knowledge and perception regarding AMR and AMS. A total of 496 students completed the questionnaire, among which, 85.7% of the participants were familiar with the term AMR and 79.4% of the participants correctly identified a poorly designed dosing regimen as a contributing factor towards AMR. The majority of participants (57.9%) were familiar with the term AMS and 86.5% were aware of the aim of AMS. The participants showed good knowledge regarding AMR and AMS, but to further improve student knowledge and perception of AMS and AMR, it is suggested that dedicated modules on antibiotic use and AMS should be incorporated into the curricula of these undergraduate and postgraduate programs.


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Mizuki Sata ◽  
Renzhe Cui ◽  
Chifa Chiang ◽  
Singeru Travis Singeo ◽  
Berry Moon Watson ◽  
...  

Abstract Background This study aimed to describe the status of alcohol consumption and drug use among young adults as well as their determinants. Methods We conducted a cross-sectional study of 356 young adults (aged 18 to 24 years) living in Palau in 2013. The prevalence of self-reported alcohol and marijuana usage were compared within and between sexes, age groups, ethnicities, and education levels. Results The proportion of current drinking was higher in people aged 21–24 than in those aged 18–20 (73.2% vs. 60.9%, p = 0.09 in men and 48.3% vs. 30.0%, p = 0.02 in women), while that of marijuana use did not differ between the age groups. The proportions of current drinking and marijuana use were higher in Palauan than in other ethnicities (current drinking: 70.6% vs. 40.6%, p = 0.005 in men and 38.8% vs. 16.6%, p = 0.04 in women; lifetime marijuana use: 80.0% vs. 52.9%, p = 0.02 in men and 56.1% vs. 30.6%, p = 0.09 in women). The proportion of frequent (3 times or more) marijuana users was higher for the lower educated than for the higher educated (62.5% vs. 32.1%, p < 0.001 in men and 33.9% vs. 24.4%, p = 0.12 in women). Conclusions Sex, age, ethnicity, and education were significant determinants of alcohol and marijuana use.


BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e046638
Author(s):  
Sk Masum Billah ◽  
Abdullah Nurus Salam Khan ◽  
S M Rokonuzzaman ◽  
Nafisa Lira Huq ◽  
Marufa Aziz Khan ◽  
...  

Study objectiveTo evaluate the competency of trained health workers in detecting and managing hypertensive disorders of pregnancy during routine antenatal check-ups (ANCs) at primary care facilities in Bangladesh.Study design and settingsCross-sectional study; conducted in 26 primary care facilities.Outcome measuresAccurate diagnosis of the hypertensive disorders of pregnancy.MethodIn total 1560 ANC consultations provided by primary health workers, known as Family Welfare Visitors (FWVs), were observed using a structured checklist between October 2017 and February 2018. All consultations were reassessed by study physicians for validation.ResultOf the ‘true’ cases of gestational hypertension (n=32), pre-eclampsia (n=29) and severe pre-eclampsia (n=16), only 3%, 7% and 25%, respectively, were correctly diagnosed by FWVs. Per cent agreement for the diagnosed cases of any hypertensive disorders of pregnancy was 9% and kappa statistics was 0.50 (p value 0.0125). For identification of any hypertensive disorders by FWVs, sensitivity and positive predictive values were 14% and 50%, respectively. There was a moderate positive correlation between the blood pressure measurements taken by FWVs and study physicians. Only 27% of those who had ‘some protein’ in urine were correctly identified by FWVs. Women diagnosed with any of the hypertensive disorders of pregnancy by FWVs were more likely to be counselled on at least one danger sign of pre-eclampsia (severe headache, blurring of vision and upper abdominal pain) than those without any such diagnosis (41% vs 19%, p value 0.008). All four cases of severe pre-eclampsia diagnosed by FWVs were given a loading dose of intramuscular magnesium sulphate and three among them were referred to a higher facility.ConclusionThe FWVs should be appropriately trained on risk assessment of pregnant women with particular emphasis on accurately assessing the diagnostic criteria of hypertensive disorders of pregnancy and its management.


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