scholarly journals Antimicrobial Stewardship from Health Professionals’ Perspective: Awareness, Barriers, and Level of Implementation of the Program

Antibiotics ◽  
2022 ◽  
Vol 11 (1) ◽  
pp. 99
Haya Nassar ◽  
Rana Abu-Farha ◽  
Muna Barakat ◽  
Eman Alefishat

This study aimed to evaluate health professionals’ perceptions regarding the level of implementation of the Antimicrobials Stewardship (AMS) programs in Jordanian tertiary hospitals and to assess the perceived barriers to its implementation. During this cross-sectional study, a total of 157 healthcare providers agreed to participate (response rate 96.3%). Participants were asked to complete an electronic survey after meeting them at their working sites. Only 43.9% of the healthcare providers (n = 69) reported having an AMS committee in their hospital settings. The results suggested that private hospitals have significantly better AMS implementation compared to public hospitals among four areas (p ≤ 0.05). Moreover, the results showed that the most widely available strategies to implement AMS were infectious disease/microbiology advice (n = 112, 71.3%), and treatment guidelines (n = 111, 70.7%). Additionally, the study revealed that the main barrier to AMS implementation was the lack of information technology support (n = 125, 79.6%). These findings could draw managers’ attention to the importance of AMS and support the health care provider’s practice of AMS in Jordanian tertiary hospitals by making the right decisions and the required modifications regarding the strategies needed for the implementation of AMS programs.

2020 ◽  
pp. postgradmedj-2020-137547
Ayman El-Menyar ◽  
Wanis H Ibrahim ◽  
Walid El Ansari ◽  
Mohamed Gomaa ◽  
Brijesh Sathian ◽  

BackgroundThe pattern and impact of burnout among the medical staff are not yet well defined. However, the consequences of burnout are not limited to the healthcare providers but also may affect their family, colleagues and patients in a negative manner. We aimed to assess the characteristics and predictors of burnout among health professionals at two large tertiary hospitals.MethodsWe conducted a cross-sectional study during the period from July 2018 to 31 December 2018. Data, via Maslach Burnout Inventory survey, were collected from physicians and other healthcare workers in two hospitals.ResultsA total of 624 responses to questionnaires were analysed. Half of the respondents were physicians, and men constituted the majority. About 10% (95% CI, 7.8 to 12.5) of the respondents satisfied the criteria of burnout. Emotional exhaustion (EE) was observed in 45.7%, depersonalisation (DP) in 26.9% and personal accomplishment (PA) in 41.2% of the respondents. There was a positive correlation between EE and DP (r=0.627, p=0.001), and a weak negative correlation between DP and PA (r=−0.195, p=0.001). Young age, less experience, trauma surgery, lack of habits and getting depressed ≥1 time/week were predictors of burnout.ConclusionsBurnout affects one-tenth of the health professionals in the tertiary hospitals in Qatar. Physicians are more likely to have higher DP and lower PA, whereas nurses prone to have higher EE. In this study, no gender discrepancy is appreciated and the junior medical staff is at a higher risk of burnout.

2020 ◽  
Cheick Oumar Bagayoko ◽  
Mahmoud Cissé ◽  
Joseph Aka ◽  
Adama Dicko ◽  
Abdrahamane Anne ◽  

Abstract Background: Mali, like many Sub-Saharan African countries, is experiencing an acute crisis with respect to the shortage of qualified health professionals. This crisis is even more acute when it comes to specialized medical fields such as dermatology. To address this shortage, a tele-dermatology project has been launched in Mali since 2015 in order to provide access to specialized care to the most remote populations.Objective: The aim of our study is to assess the medico-economic benefits of the pilot phase of this project.Methods: We conducted a retrospective cross-sectional study of all requests for expert advice sent to dermatology experts through the "Bogou" tele-expertise platform.The sample consisted of 52 patients at eight remote sites and ten health professionals, including 4 specialists.The economic study was done using a parameter of cost analysis and the professional evaluation of healthcare providers. It compared consultation and transportation fees (on-site and off-site), and used a questionnaire assessing items on a 5-level Lickert scale and open-ended questions to evaluate the satisfaction of health professionals. Data analysis was performed by SPSS v25.Results: During the period, 374 requests for tele-expertise were made for the benefit of 52 patients. 89.3% of requests were answered by specialists, with an average response time of 46 hours 59 minutes and extremes from 7 minutes to 415 hours 4 minutes. Eczema was the most common medical condition diagnosed. 98% of patients had never completed a dermatological consultation because of a lack of means to travel to the only specialized center in the country. Consequently, they were all very satisfied or satisfied with the tele-expertise service. The 52 participating patients in project have realized a great financial benefit. Together they saved an average of 5,824,500 XOF (9429 euros).All the health professionals surveyed also expressed satisfaction with the application. They confirmed that the project has enabled them to strengthen their skills in the management of dermatological pathologies.Conclusion: Based on the results of our study, we can say that tele-dermatology allows access to specialized care and a reduction in the costs of care for patients in remote areas.

2019 ◽  
Leonard O. Ajah ◽  
Fidelis A. Onu ◽  
Oliver C. Ogbuinya ◽  
Monique I. Ajah ◽  
Benjamin C. Ozumba ◽  

AbstractBackgroundLow utilization of health facilities for delivery by pregnant women poses a public health challenge in Nigeria.AimTo determine the factors that influence the choice of birth place among antenatal clinic attendees.MethodologyThis was a cross-sectional study of the eligible antenatal clinic attendees at Mater Misericordiae Hospital, Afikpo and Saint Vincent Hospital, Ndubia in Ebonyi State from February 1, 2016 to June 30, 2016. Analysis was done using EPI Info 7.21 software (CDC Atlanta Georgia).ResultsA total of 397(99.3%) completely filled questionnaires were collated and analysed. Approximately 71% of the health facilities closest to the respondents had maternity services. It took at least 1 hour for 80.9% of the respondents to access health facilities with maternity services. Most (60.2%) of the respondents had antenatal care attendance and majority of them did so at public hospitals. Approximately 43.8% of the respondents were delivered by the skilled birth attendants. The common determinants of birth place were nearness of the health facilities, familiarity of healthcare providers, improved services, sudden labour onset and cost. Also 61.7% of the respondents chose to deliver in public health facilities due to favourable reasons but this could be hampered by the rudeness of some healthcare providers at such facilities. A significant proportion of private health facilities had unskilled manpower and shortage of drugs.ConclusionA greater proportion of women will prefer to deliver in health facilities. However there are barriers to utilization of these facilities hence the need for reversal of this ugly trend.

Akhenaten Siankam Tankwanchi ◽  
Amy Hagopian ◽  
Sten H. Vermund

Research in assessing the global and asymmetric flows of health workers in general, and international medical graduates in particular, is fraught with controversy. The complex goal of improving health status of the citizens of home nations while ensuring the right of health workers to migrate generates policy discussions and decisions that often are not adequately informed by evidence. In times of global public health crises like the current coronavirus disease 2019 (COVID-19) global pandemic, the need for equitable distribution and adequate training of health workers globally becomes even more pressing. Brugha et al report suboptimal training and working conditions among Irish and foreign medical doctors practicing in Ireland, while predicting large-scale outward migration. We comment on health personnel migration and retention based on our own experience in this area of research. Drawing from our examination of medical migration dynamics from sub-Saharan Africa, we argue for greater consideration of health workforce retention in research and policy related to resource-limited settings. The right to health suggests the need to retain healthcare providers whose education was typically subsidized by the home nation. The right to migrate may conflict with the right to health. Hence, a deeper understanding is needed as to healthcare worker motives based on interactions of psychosocial processes, economic and material determinants, and quality of work environments.

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e037103
Afework Tadele ◽  
Mahilet Berhanu

ObjectivesAlthough nationally representative data are helpful in designing strategies and policies of programmes in a country, there is paucity of evidence with regard to trends and factors influencing utilisation of long-acting contraceptives (LACs). Thus, this study aimed to assess the trends and factors influencing LAC utilisation among contraceptive users in Ethiopia.DesignA repeated cross-sectional study.Setting and participantsThe Performance Monitoring and Accountability (PMA2020) national community-based survey data were used, and 2035 contraceptive users participated. To identify trends, proportions of LAC users were analysed using PMA data from round 1 in January 2014 to round 6 in July 2018.Main outcome measuresUsers using LAC methods or otherwise.ResultsThere was a difference in trends in LAC utilisation in the last 4.5 years. There was a 7% increase in the proportion of implant users, while there were no significant changes in utilisation of intrauterine device and female sterilisation. Women in the middle wealth quintile were 1.7 times more likely than those in the lowest quintile to use LAC, while contraceptive users who received recommendations from healthcare providers as well as those who made decisions jointly with healthcare providers were more likely to use LAC compared with those who decided on their own. Women with access to their desired method of contraception were less likely to use LAC, while those informed about intrauterine contraceptive device were more likely to use LAC compared with their counterparts. Women served at health posts, private hospitals and others (family planning clinics, pharmacies and non-governmental organisations) were less likely to use LAC compared with women served at public hospitals.ConclusionOverall the utilisation of LAC in Ethiopia is low. Therefore, much has to be done in terms of raising awareness about intrauterine device, how healthcare providers can help users in choosing contraceptive methods, and sharing of experiences between public hospitals and other family planning service delivery points.

2017 ◽  
Vol 5 (2) ◽  
pp. 243-249 ◽  
Roubina Kousar ◽  
Robina Kousar ◽  
Muhammad Azhar ◽  
Ali Waqas ◽  
Syed Amir Gilani

Aim: The aim of this study was to assess the barriers of research utilization among nurses of public hospitals Lahore, Pakistan. Methodology: Descriptive cross sectional study was used. This study was conducted among nurses of  Mayo Hospital Lahore and Lady Aitchison Hospital Lahore. The data was collected through simple random sampling from 245 registered nurses from both hospitals. The questionnaire of barriers to research utilization developed by Funk et al. (1993) was used. Result: The current study results show that nurses didn’t utilize the research in practices. Non-supportive organization, colleagues, inadequate facilities, insufficient time, nurse feels she has no authority to change patient care procedure, research factor and nursing factor is the main barrier of research utilization. In the future nurses should come on a paradigm of research. Conclusion: This reveals that management should increase the focus on nurse’s knowledge and facilities about research utilizationInt. J. Appl. Sci. Biotechnol. Vol 5(2): 243-249

2021 ◽  
Vol 9 (1) ◽  
pp. 8
Dr. Kenneth Ogar Inaku ◽  
Dr. Ifeyinwa Dorothy Nnakenyi ◽  
Dr. Lucius Chidebere Imohc ◽  
Dr. Akeem Oyeyemi Lawal ◽  
Dr. Emin Johnson Emine ◽  

Introduction: An estimated 6.3 million Nigerians were reported to have prediabetes in 2015 placing Nigeria in the 9th position in world ranking. This number is projected to become 12.9 million by 2040. One way of reversing this trend is early identification of individuals at risk. This study was carried out to assess the knowledge, attitudes and practice of health care providers toward prediabetes diagnosis and management. Methods: This was an observational-based cross-sectional study involving the use of self administered questionnaire to doctors from the departments of internal medicine, paediatrics, obstetrics and gynaecology, family medicine and others. Results: In all, 358 questionnaires out of 410 were selected. All 10 risk factors for prediabetes were correctly identified by 82/358 (22.9%) participants with 300/358 (83.8%) able to identify at least 5 risk factors. Laboratory reference interval of 5.6 – 6.9 mmol/L for diagnosing prediabetes using fasting plasma glucose were correctly identified by 70/358 (19.6%) (lower value) and 14.5% (upper value) respectively. American Diabetes Association guidelines for prediabetes screening was the most familiar to 272(76.0%) respondents even though 144/358(40.2%) do not consider prediabetes as a condition that requires specific management. Over half 186/358(52%) of respondents agreed that metformin use can reduce the risk of diabetes in individuals with prediabetes but only 6/358(1.7%) have ever discussed starting metformin with their patients. Conclusion: There is need to educate medical doctors about risk factors for prediabetes and its management to curb the rising diabetes epidemic in Nigeria.

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e031484 ◽  
Farah Diba ◽  
Ichsan Ichsan ◽  
Muhsin Muhsin ◽  
Marthoenis Marthoenis ◽  
Hizir Sofyan ◽  

ObjectivesOur study investigates the barriers perceived by staff in the referral systems in maternal healthcare facilities across Aceh province in Indonesia.DesignWith a cross-sectional approach, two sets of surveys were administered during September to October 2016 in 32 sampling units of our study. We also collected referral data in the form of the frequency of ingoing and outgoing referral cases per facility.SettingIn three districts, Aceh Besar, Banda Aceh and Bireuen, a total of 32 facilities including hospitals, community health centres, and private midwife clinics that met the criteria of providing at least basic emergency obstetric and neonatal care (BEonC) were covered.ParticipantsAcross the 32 healthcare centres, 149 members of staff (mainly midwives) agreed to participate in our surveys.Primary and secondary outcome measuresThe first survey consisted of 65 items focusing on organisational measures as well as case numbers for example, patient counts, mortality rate and complications. The second survey with 68 items asked healthcare providers about a range of factors including attitudes towards the referral process in their facility and potential barriers to a well-functioning system in their district.ResultsOverall, mothers’/families’ consent as well as the complex administration process were found to be the main barriers (36% and 12%, respectively). Healthcare providers noted that information about other facilities has the biggest room for improvement (37%) rather than transport, timely referral of mothers and babies, or the availability of referral facilities.ConclusionsThe largest barrier perceived by healthcare providers in our study was noted to be family consent and administrative burden. Moreover, lack of information about the referral system itself and other facilities seemed to be affecting healthcare providers and mothers/families alike and improvements perhaps through a shared information system is needed.

2021 ◽  
Vol 49 (1) ◽  
Demisu Zenbaba ◽  
Biniyam Sahiledengle ◽  
Abulie Takele ◽  
Yohannes Tekalegn ◽  
Ahmed Yassin ◽  

Abstract Introduction The new coronavirus disease 2019 is an emerging respiratory disease caused by the highly contagious novel coronavirus which has currently overwhelmed the world. Realizing a comprehensive set of infection prevention measures is a key to minimize the spread of this virus and its impacts in all healthcare settings. Therefore, this study was aimed to assess the compliance towards COVID-19 preventive measures and associated factors among health professionals in selected public hospitals, southeast Ethiopia. Methods A descriptive hospital-based cross-sectional study was conducted among 660 health professionals in public hospitals of southeast Ethiopia from October 1 to 31, 2020. A multistage sampling technique was used to select the study participants. Data were collected by interview using structured and pretested questionnaires. Ordinary logistic regression modeling was used to estimate the crude and adjusted odds ratio. To declare the statistical significance of factors associated with the outcome variable, P-value < 0.05 and 95% confidence interval were used. Results A total of 654 health professionals were involved in the study; of whom, 313 participants were nurses. The overall good compliance and knowledge of health professionals regarding COVID-19 preventive measures were 21.6 and 25.5%, respectively. Working in the general hospital (AOR = 0.55; 95% CI 0.38, 0.79), service year (AOR = 2.10; 95% CI 1.35, 3.21), knowledge (AOR = 1.80; 95% CI 1.14, 2.89), and water availability (AOR = 3.26; 95% CI 2.25, 4.72) were some of the factors found to have a statistically significant association to compliance of health professionals regarding COVID-19 preventive measures. Conclusion In this study, nearly one fifth of health professionals had good compliance towards COVID-19 prevention practices. Thus, a consistent supply of COVID-19 prevention materials, facilities, and improving the knowledge of health professionals through on and off-job training are crucial.

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