Antimicrobial stewardship and antimicrobial resistance in wound management: The role of pharmacists

WCET Journal ◽  
2021 ◽  
Vol 41 (4) ◽  
Author(s):  
Karen Ousey ◽  
Geoff Sussman
Keyword(s):  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
Wound Management

scholarly journals Infection Prevention Control (IPC) and Antimicrobial Resistance (AMR)

2020 ◽  
pp. 53-80
Author(s):  
Louise Ackers ◽  
Gavin Ackers-Johnson ◽  
Joanne Welsh ◽  
Daniel Kibombo ◽  
Samuel Opio
Keyword(s):  
Antimicrobial Resistance ◽  
Hand Hygiene ◽  
Infection Control ◽  
Waste Disposal ◽  
Antimicrobial Stewardship ◽  
Infection Prevention ◽  
Wound Management ◽  
Central Focus ◽  
Maternal Sepsis

AbstractThis chapter outlines a key component of improved AMR; namely infection prevention control (IPC). It addresses some of the issues most commonly associated with IPC including hand hygiene, waste disposal and infrastructure. It then addresses wound management as an Infection Control issue. The emergence of wound management as a central focus in the Maternal Sepsis Intervention proved pivotal in shaping the pathway to antimicrobial stewardship.

scholarly journals Exploring perspectives on antimicrobial stewardship: a qualitative study of health managers in Kenya

2020 ◽  
Author(s):  
Samuel MUNGAI Mbugua ◽  
George Njoroge ◽  
Caroline Kijogi ◽  
Moses Kamita ◽  
Rachel Kimani ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Health Services ◽  
Antimicrobial Stewardship ◽  
Building Blocks ◽  
Health Concern ◽  
Surveillance Systems ◽  
Sensitivity Testing ◽  
Therapeutics Committee ◽  
Health Managers

Abstract Background: Antimicrobial resistance is a significant public health concern with the establishment of antimicrobial stewardship in hospitals being obligatory now more than ever. The perspectives and insights of health managers on antimicrobial stewardship (AMS), the complementary health services and building blocks are imperative towards implementation of robust antimicrobial stewardship programs. This study aimed to understand the perspectives of hospital managers to AMS and identify areas of management engagement and addressing potential blockades to change.Methods: A cross-sectional, qualitative, multicenter study was conducted in three hospitals in Kenya. Key-informant, face-to-face interviews with hospital health managers were carried out on their perspectives on antimicrobial stewardship. Qualitative data was captured using audio tapes and field notes, transcribed and managed using NVivo 12 software. An iterative process was used to develop the thematic framework and updated in two rounds of iteration analysis. Analysis charts for each emergent theme were developed and categorized across all participants.Results: Perspectives on antimicrobial stewardship are described in five thematic categories; Importance of antimicrobial stewardship and the role of medicines and therapeutics committee, availability of an antimicrobial formulary and usage surveillance systems, laboratory competency and recommendations for infection prevention and management, educational resources and communications channels available, building blocks and low-lying fruits for Antimicrobial Stewardship Committees. The role of stewardship collaboration in diagnosis and antimicrobial prescription was alluded to with managers indicating a growing rise in occurrence of antimicrobial resistance. There was no contextualized, hospital specific antimicrobial formulary based on the local antibiograms in any of the hospitals. Lack of adequate laboratory competency was a major deficit with most hospitals lacking culture and sensitivity testing services. Staff training and communication channels were available in varying capacity across the three hospitals. Building blocks identified include medicines and therapeutics committee, education, and training platforms (Continuous Medical Education and Continuous Professional Development activities) and hospital leadership commitment towards antimicrobial stewardship.Conclusions: The practice of antimicrobial stewardship is not implemented and well developed in the sampled healthcare facilities as demonstrated by lack of core AMS complementary health services. However, the health managers are aware of the fundamental importance of antimicrobial stewardship programs and the vast benefits of implementation and institutionalization of AMS to the hospital and its clients alike. The findings underpin the importance of understanding and incorporating the perspectives of health managers on the existing contextual mechanisms that can be leveraged on to establish robust Antimicrobial Stewardship programs in the fight against antimicrobial resistance.

scholarly journals Exploring perspectives on antimicrobial stewardship: a qualitative study of health managers in Kenya

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Samuel Mungai Mbugua ◽  
George Njoroge ◽  
Caroline Kijogi ◽  
Moses Kamita ◽  
Rachel Kimani ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Health Services ◽  
Antimicrobial Stewardship ◽  
Building Blocks ◽  
Health Concern ◽  
Surveillance Systems ◽  
Hospital Managers ◽  
Therapeutics Committee ◽  
Health Managers

Abstract Background Antimicrobial resistance is a significant public health concern with the establishment of antimicrobial stewardship in hospitals being increasingly obligatory. Perspectives and insights of health managers on antimicrobial stewardship (AMS), complementary health services and building blocks are imperative towards implementation of robust AMS programs. This study aimed to understand perspectives of hospital managers on AMS and identify areas of management engagement while addressing potential blockades to change. Methods A cross-sectional, qualitative, multicenter study was conducted in three hospitals in Kenya. Key-informant interviews on perspectives on AMS were administered to hospital managers. Qualitative data was captured using audio tapes and field notes, transcribed and managed using NVivo 12 software. An iterative process was used to develop the thematic framework and updated in two rounds of iteration analysis. Analysis charts for each emergent theme were developed and categorized across all participants. Results Perspectives on AMS are described in five thematic categories; Importance of antimicrobial stewardship and the role of medicines and therapeutics committee, availability of antimicrobial formulary and usage surveillance systems, laboratory competency and recommendations for infection prevention and management, educational resources and communications channels available, building blocks and low-lying fruits for Antimicrobial Stewardship Committees. The role of stewardship collaboration in diagnosis and antimicrobial prescription was alluded to with managers indicating a growing rise in occurrence of antimicrobial resistance. There lacked contextualized, hospital specific antimicrobial formulary and adequate laboratory competency. Staff training and communication channels were available in varying capacity across the three hospitals. Building blocks identified include medicines and therapeutics committee, education, and training platforms (Continuous Medical Education and Continuous Professional Development activities) and hospital leadership commitment. Conclusions The practice of antimicrobial stewardship is not implemented and well developed as demonstrated by lack of core AMS complementary health services. However, the health managers are aware of the fundamental importance of antimicrobial stewardship programs and the vast benefits of implementation and institutionalization of AMS to hospitals and their clients. The findings underpin the importance of understanding and incorporating perspectives of health managers on existing contextual mechanisms that can be leveraged on to establish robust AMS programs in the fight against antimicrobial resistance.

scholarly journals Exploring perspectives on antimicrobial stewardship: a qualitative study of health managers in Kenya

2020 ◽  
Author(s):  
Samuel Mungai Mbugua ◽  
George Njoroge ◽  
Caroline Kijogi ◽  
Moses Kamita ◽  
Rachel Kimani ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Health Services ◽  
Antimicrobial Stewardship ◽  
Building Blocks ◽  
Health Concern ◽  
Surveillance Systems ◽  
Hospital Managers ◽  
Therapeutics Committee ◽  
Health Managers

Abstract Background: Antimicrobial resistance is a significant public health concern with the establishment of antimicrobial stewardship in hospitals being increasingly obligatory. Perspectives and insights of health managers on antimicrobial stewardship (AMS), complementary health services and building blocks are imperative towards implementation of robust AMS programs. This study aimed to understand perspectives of hospital managers on AMS and identify areas of management engagement while addressing potential blockades to change.Methods: A cross-sectional, qualitative, multicenter study was conducted in three hospitals in Kenya. Key-informant interviews on perspectives on AMS were administered to hospital managers. Qualitative data was captured using audio tapes and field notes, transcribed and managed using NVivo 12 software. An iterative process was used to develop the thematic framework and updated in two rounds of iteration analysis. Analysis charts for each emergent theme were developed and categorized across all participants.Results: Perspectives on AMS are described in five thematic categories; Importance of antimicrobial stewardship and the role of medicines and therapeutics committee, availability of antimicrobial formulary and usage surveillance systems, laboratory competency and recommendations for infection prevention and management, educational resources and communications channels available, building blocks and low-lying fruits for Antimicrobial Stewardship Committees. The role of stewardship collaboration in diagnosis and antimicrobial prescription was alluded to with managers indicating a growing rise in occurrence of antimicrobial resistance. There lacked contextualized, hospital specific antimicrobial formulary and adequate laboratory competency. Staff training and communication channels were available in varying capacity across the three hospitals. Building blocks identified include medicines and therapeutics committee, education, and training platforms (Continuous Medical Education and Continuous Professional Development activities) and hospital leadership commitment.Conclusions: The practice of antimicrobial stewardship is not implemented and well developed as demonstrated by lack of core AMS complementary health services. However, the health managers are aware of the fundamental importance of antimicrobial stewardship programs and the vast benefits of implementation and institutionalization of AMS to hospitals and their clients. The findings underpin the importance of understanding and incorporating perspectives of health managers on existing contextual mechanisms that can be leveraged on to establish robust AMS programs in the fight against antimicrobial resistance.

scholarly journals Exploring Perspectives on Antimicrobial Stewardship: A Qualitative Study of Health Managers in Kenya

2020 ◽  
Author(s):  
Samuel Mungai Mbugua ◽  
George Njoroge ◽  
Caroline Kijogi ◽  
Moses Kamita ◽  
Rachel Kimani ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
Building Blocks ◽  
Health Concern ◽  
Surveillance Systems ◽  
Sensitivity Testing ◽  
Cross Sectional ◽  
Therapeutics Committee ◽  
Health Managers

Abstract Background: Antimicrobial resistance is a significant public health concern with the establishment of antimicrobial stewardship in hospitals being obligatory now more than ever. The perspectives and insights of health managers on antimicrobial stewardship, the complementary health services and building blocks are imperative towards implementation of robust antimicrobial stewardship programs.Methods: A cross-sectional, qualitative, multicenter study was conducted in three hospitals in Kenya. Key-informant, face-to-face interviews with hospital health managers were carried out on their perspectives on antimicrobial stewardship. Qualitative data was captured using audio tapes and field notes, transcribed and managed using QSR Nvivo 12 software. An iterative process was used to develop the thematic framework and updated in two rounds of iteration analysis. Analysis charts for each emergent theme were developed and categorized across all participants.Results: Perspectives on antimicrobial stewardship are described in five thematic categories; Importance of antimicrobial stewardship and the role of medicines and therapeutics committee, availability of an antimicrobial formulary and usage surveillance systems, Laboratory competency and recommendations for infection prevention and management, Educational resources and communications channels available, Building blocks and low-lying fruits for ASCs. The role of stewardship collaboration in diagnosis and antimicrobial prescription was alluded to with managers indicating a growing rise in occurrence of antimicrobial resistance. There was no contextualized, hospital specific antimicrobial formulary based on the local antibiograms in any of the hospitals. Lack of adequate laboratory competency was a major deficit with most hospitals lacking culture and sensitivity testing services. Staff training and communication channels were available in varying capacity across the three hospitals. Building blocks identified include medicines and therapeutics committee, education and training platforms (CMEs and CPDs) and hospital leadership commitment towards antimicrobial stewardship.Conclusions: The findings underpin the importance of understanding and incorporating the perspectives of health managers on the existing contextual mechanisms that can be leveraged on to establish robust AMS programs in the fight against AMR.

scholarly journals Role of Artificial Intelligence in Fighting Antimicrobial Resistance in Pediatrics

Antibiotics ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 767 ◽  
Author(s):  
Umberto Fanelli ◽  
Marco Pappalardo ◽  
Vincenzo Chinè ◽  
Pierpacifico Gismondi ◽  
Cosimo Neglia ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
Potential Role ◽  
Antimicrobial Agents ◽  
Primary Role ◽  
Science And Engineering ◽  
Intelligent Behavior ◽  
Applications Of Ai

Artificial intelligence (AI) is a field of science and engineering concerned with the computational understanding of what is commonly called intelligent behavior. AI is extremely useful in many human activities including medicine. The aim of our narrative review is to show the potential role of AI in fighting antimicrobial resistance in pediatric patients. We searched for PubMed articles published from April 2010 to April 2020 containing the keywords “artificial intelligence”, “machine learning”, “antimicrobial resistance”, “antimicrobial stewardship”, “pediatric”, and “children”, and we described the different strategies for the application of AI in these fields. Literature analysis showed that the applications of AI in health care are potentially endless, contributing to a reduction in the development time of new antimicrobial agents, greater diagnostic and therapeutic appropriateness, and, simultaneously, a reduction in costs. Most of the proposed AI solutions for medicine are not intended to replace the doctor’s opinion or expertise, but to provide a useful tool for easing their work. Considering pediatric infectious diseases, AI could play a primary role in fighting antibiotic resistance. In the pediatric field, a greater willingness to invest in this field could help antimicrobial stewardship reach levels of effectiveness that were unthinkable a few years ago.

scholarly journals Exploring perspectives on antimicrobial stewardship: a qualitative study of health managers in Kenya

2020 ◽  
Author(s):  
Samuel MUNGAI Mbugua ◽  
George Njoroge ◽  
Caroline Kijogi ◽  
Moses Kamita ◽  
Rachel Kimani ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
Building Blocks ◽  
Health Concern ◽  
Surveillance Systems ◽  
Sensitivity Testing ◽  
Cross Sectional ◽  
Therapeutics Committee ◽  
Health Managers

Abstract Background: Antimicrobial resistance is a significant public health concern with the establishment of antimicrobial stewardship in hospitals being obligatory now more than ever. The perspectives and insights of health managers on antimicrobial stewardship, the complementary health services and building blocks are imperative towards implementation of robust antimicrobial stewardship programs.Methods: A cross-sectional, qualitative, multicenter study was conducted in three hospitals in Kenya. Key-informant, face-to-face interviews with hospital health managers were carried out on their perspectives on antimicrobial stewardship. Qualitative data was captured using audio tapes and field notes, transcribed and managed using QSR Nvivo 12 software. An iterative process was used to develop the thematic framework and updated in two rounds of iteration analysis. Analysis charts for each emergent theme were developed and categorized across all participants.Results: Perspectives on antimicrobial stewardship are described in five thematic categories; Importance of antimicrobial stewardship and the role of medicines and therapeutics committee, availability of an antimicrobial formulary and usage surveillance systems, Laboratory competency and recommendations for infection prevention and management, Educational resources and communications channels available, Building blocks and low-lying fruits for ASCs. The role of stewardship collaboration in diagnosis and antimicrobial prescription was alluded to with managers indicating a growing rise in occurrence of antimicrobial resistance. There was no contextualized, hospital specific antimicrobial formulary based on the local antibiograms in any of the hospitals. Lack of adequate laboratory competency was a major deficit with most hospitals lacking culture and sensitivity testing services. Staff training and communication channels were available in varying capacity across the three hospitals. Building blocks identified include medicines and therapeutics committee, education and training platforms (CMEs and CPDs) and hospital leadership commitment towards antimicrobial stewardship.Conclusions: The findings underpin the importance of understanding and incorporating the perspectives of health managers on the existing contextual mechanisms that can be leveraged on to establish robust AMS programs in the fight against AMR.

Antimicrobial resistance: The fundamental role of primary care

2021 ◽  
pp. 175573802110392
Author(s):  
Emily Brown
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Antimicrobial Resistance ◽  
Global Health ◽  
Antimicrobial Agent ◽  
Antimicrobial Stewardship ◽  
Antibiotic Prescribing ◽  
The World ◽  
Primary Care Clinicians

Antimicrobial resistance (AMR) develops when microbes, such as bacteria, evolve to no longer be susceptible to an antimicrobial agent. AMR is a huge concern, being regarded internationally as one of the current top 10 threats to global health. By 2050, it is predicted that AMR will be responsible for more deaths globally than cancer. Countries around the world are rising to the challenge of reducing antimicrobial resistance, and primary care has a key role in this objective, as the vast majority of antibiotic prescribing takes place in the community. This article will explore the challenges facing primary care clinicians regarding antimicrobial stewardship and will consider approaches in day-to-day general practice that can help tackle AMR, including a number of helpful and easy to use resources. Future considerations and innovative technologies will also be discussed.

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