scholarly journals Feasibility and Validity of a Framework for Antimicrobial Stewardship in General Practice: Key Stakeholder Interviews

Antibiotics ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. 900
Author(s):  
Lesley A. Hawes ◽  
Jaclyn Bishop ◽  
Kirsty Buising ◽  
Danielle Mazza
Keyword(s):  
General Practice ◽  
Antimicrobial Stewardship ◽  
Antibiotic Prescribing ◽  
Community Based ◽  
The Public ◽  
Professional Groups ◽  
Key Stakeholders ◽  
Secondary Objective ◽  
Further Development

There is little guidance about developing systems for antimicrobial stewardship (AMS) for general practice. A literature review identified six key components: governance, monitoring of antibiotic prescribing and resistance with feedback to prescribers, consultation support, education of the public and general practitioners, pharmacist and nurse involvement, and research, which were incorporated into a potential framework for the general practice context. Objectives: to determine the feasibility and validity of the proposed AMS framework. A secondary objective was to identify likely bodies responsible for implementation in Australia. We undertook interviews with 12 key stakeholders from government, research, and professional groups. Data were analysed with a thematic approach. The framework was considered valid and feasible. No clear organisation was identified to lead AMS implementation in general practice. The current volume-based antibiotic prescription monitoring system was considered insufficient. AMS education for the public, further development of GP education, and improved consultation support were strongly recommended. The role of community-based pharmacists and nurses is largely unexplored, but their involvement was recommended. A clear leader to drive AMS in general practice is essential for an action framework to gain traction. Monitoring and feedback of antibiotic prescribing require urgent development to include monitoring of prescribing appropriateness and patient outcomes.

scholarly journals Antimicrobial Stewardship in General Practice: A Scoping Review of the Component Parts

Antibiotics ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 498 ◽  
Author(s):  
Lesley Hawes ◽  
Kirsty Buising ◽  
Danielle Mazza
Keyword(s):  
General Practice ◽  
Health System ◽  
Antimicrobial Stewardship ◽  
Scoping Review ◽  
Action Plan ◽  
Information Resources ◽  
Antibiotic Prescribing ◽  
National Action Plan ◽  
The Public

There is no published health-system-wide framework to guide antimicrobial stewardship (AMS) in general practice. The aim of this scoping review was to identify the component parts necessary to inform a framework to guide AMS in general practice. Six databases and nine websites were searched. The sixteen papers included were those that reported on AMS in general practice in a country where antibiotics were available by prescription from a registered provider. Six multidimensional components were identified: 1. Governance, including a national action plan with accountability, prescriber accreditation, and practice level policies. 2. Education of general practitioners (GPs) and the public about AMS and antimicrobial resistance (AMR). 3. Consultation support, including decision support with patient information resources and prescribing guidelines. 4. Pharmacist and nurse involvement. 5. Monitoring of antibiotic prescribing and AMR with feedback to GPs. 6. Research into gaps in AMS and AMR evidence with translation into practice. This framework for AMS in general practice identifies health-system-wide components to support GPs to improve the quality of antibiotic prescribing. It may assist in the development and evaluation of AMS interventions in general practice. It also provides a guide to components for inclusion in reports on AMS interventions.

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.

Assessing the uptake and effectiveness of a quick reference guide to antibiotic prescribing in Australian general practice

2016 ◽  
Vol 22 (6) ◽  
pp. 565 ◽  
Author(s):  
Angus Thompson ◽  
Patrick O'Sullivan ◽  
Elisabeth Banham ◽  
Greg Peterson
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Antimicrobial Stewardship ◽  
Antibiotic Prescribing ◽  
Duration Of Treatment ◽  
Reference Guide ◽  
Treatment Dose ◽  
Dosing Frequency ◽  
Australian General Practice ◽  
Prescribing Practice

Prescribing guidelines are an essential component of antimicrobial stewardship programs in Australian hospitals. Nonetheless, the majority of antibiotic prescribing occurs in the community and the effectiveness of guidelines developed specifically to meet the needs of Australian general practice is unknown. This study aims to assess the uptake and effectiveness of a quick reference guide to antibiotic prescribing among primary care prescribers. A quick reference guide to antibiotic prescribing was developed and prescribers in five Tasmanian practices were surveyed regarding use of this guide. Thirty-three surveys were returned and, of those answering specific sections, 75% were aware of the guide and 71% had used it within the last month. The guide affected the antibiotic prescribing practice of 74% of responding prescribers; most often on choice of antibiotic; but also on duration of treatment, dose and dosing frequency. A quick reference guide to antibiotic prescribing was well received by prescribers and may usefully support efforts to improve antimicrobial stewardship in the community.

Stakeholder responses to government austerity: what happens when strong stakeholders fail to react?

2016 ◽  
Vol 83 (1) ◽  
pp. 129-148 ◽  
Author(s):  
Ken Ogata
Keyword(s):  
Stakeholder Theory ◽  
Historical Case Study ◽  
Public Administrators ◽  
Historical Case ◽  
The Public ◽  
Professional Groups ◽  
Public Sentiment ◽  
Key Stakeholders ◽  
The Government ◽  
Advocacy Role

Using stakeholder theory and a historical case study, I examine how key stakeholders failed to challenge the Alberta provincial government’s fiscal reforms, leading to the emergence of an unlikely champion in the Calgary hospital laundry workers. Notwithstanding that several prominent and powerful professional groups had the opportunity to oppose the government’s reforms, these groups either acquiesced or sought compromise individually with the government. This case calls into question the professions’ ability to protect public institutions under their domain. Points for practitioners In terms of potential implications for public administrators, this case provides an example of professional failure to intercede in the public interest, despite having the power and legitimacy to act according to stakeholder theory. This raises questions as to the circumstances under which professional groups will exercise their advocacy role. Unaddressed are the conditions under which relatively powerless demanding stakeholders can acquire power and legitimacy. Accordingly, administrators ‘relying’ upon established stakeholders as barometers of public opinion may misread public sentiment.

scholarly journals Engaging people with long-term health conditions in a community-based physical activity initiative: a qualitative follow-up study evaluating the parkrun PROVE project

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Helen Quirk ◽  
Steve Haake
Keyword(s):  
Physical Activity ◽  
Health Condition ◽  
Project Manager ◽  
Health Conditions ◽  
Management Communication ◽  
Community Based ◽  
The Public ◽  
Key Stakeholders

Abstract Background The “parkrun: running or volunteering for everyone” (PROVE) project was an example of a community-based physical activity and volunteering initiative for people living with long-term health conditions in England. The 3 year project involved appointing volunteer Outreach Ambassadors whose role was to promote parkrun to people living with long-term health conditions through various outreach activities. This qualitative study aimed to understand the experience of delivering the project from the perspective of volunteer Outreach Ambassadors and the PROVE Project Manager. Methods The PROVE Project Manager and ten PROVE Outreach Ambassadors across nine health condition groups were interviewed by the researcher (asthma, blood pressure, deaf and hard of hearing, dementia, diabetes, endometriosis, heart conditions, learning disabilities and/or autism, and obesity). Interview transcripts were analysed using thematic analysis. Results Four themes and nine sub-themes were generated. The participants highlighted challenges in measuring the project’s success and bringing about meaningful and lasting change, and reflected on the value of the project as a learning opportunity. Despite some successes, it was thought that the project had limited reach outside of the existing parkrun community. The Outreach Ambassadors reflected on their experiences in the role and the skills required, finding it rewarding and highlighting the importance of networking and forming connections with key stakeholders. The findings are discussed in comparison to interviews conducted with the Outreach Ambassadors 12 months earlier. Conclusions This study provides evidence to support the public health potential of parkrun though targeted initiatives such as the PROVE project and provides a critical reflection on what worked and what did not work when delivering the project. The findings have relevance for organisations wishing to implement similar outreach initiatives using a volunteer workforce, including recommendations for resource management, communication, leadership, fostering volunteer autonomy and defining and capturing success.

scholarly journals Gauging the stakeholders’ perspective: towards PPP in building sectors and housing

2020 ◽  
Vol 35 (4) ◽  
pp. 1123-1156
Author(s):  
Ritika Batra
Keyword(s):  
Building Industry ◽  
End User ◽  
Housing Provision ◽  
The Public ◽  
Current Trends ◽  
Key Stakeholders ◽  
User Acceptability ◽  
Survey Results ◽  
Major Factors

Abstract While Public-Private Partnership (PPP) is widely adopted across various sectors, it raises a question on its meagre utilisation in the housing sector. This paper, therefore, gauges the perspective of the stakeholders in the building industry towards the application of PPP in various building sectors together with housing. It assesses the performance reliability of PPP for housing by learning possible take-aways from other sectors. The role of key stakeholders in the industry becomes highly responsible for an informed understanding and decision-making. To this end, a two-tier investigation was conducted including surveys and expert interviews, with several stakeholders in the PPP industry in Europe, involving the public sector, private sector, consultants, as well as other community/user representatives. The survey results demonstrated the success rate with PPPs, major factors important for PPPs such as profitability or end-user acceptability, the prevalent practices and trends in the PPP world, and the majority of support expressed in favour of the suitability of PPP for housing. The interviews added more detailed dimensions to the understanding of the PPP industry, its functioning and enabling the formation of a comprehensive outlook. The results present the perspective, approaches, and experiences of stakeholders over PPP practices, current trends and scenarios and their take on PPP in housing. It shall aid in understanding the challenges prevalent in the PPP approach for implementation in housing and enable the policymakers and industry stakeholders to make provisions for higher uptake to accelerate housing provision.

Presenting primary care teams to the public: a qualitative exploration of general practice websites

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697049
Author(s):  
Helen Anderson ◽  
Joy Adamson ◽  
Yvonne Birks
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Nurse Practitioners ◽  
Primary Healthcare ◽  
Healthcare Providers ◽  
Patient Choice ◽  
Healthcare Team ◽  
Sufficient Information ◽  
The Public ◽  
Professional Groups

BackgroundIncreasing demand and expanded primary care provision, coupled with a reduced GP workforce present challenges for primary care. New workforce models aim to reduce general practitioner workload by directing patients to a variety of alternative clinicians. Concurrently, the principle of patient choice in relation to healthcare providers has gained prominence. It is, therefore, necessary to provide patients with sufficient information to negotiate access to appropriate primary healthcare professionals.AimTo explore how practice websites present three exemplar healthcare professional groups (GPs, advanced nurse practitioners [ANPs], and practice nurses [PNs]) to patients and the implications for informing appropriate consultation choices.MethodQualitative thematic analysis of a sample of general practice websites. 79 accessible websites from a district in England were thematically analysed in relation to professional representation and signposting of the three identified professional groups.ResultsInformation about each group was incomplete, inconsistent and sometimes inaccurate across the majority of general practice websites. There was a lack of coherence and strategy in representation and direction of website users towards appropriate primary healthcare practitioners.ConclusionLimited and unclear representation of professional groups on general practice websites may have implications for the direction of patients to the wider clinical healthcare team. Patients may not have appropriate information to make choices about consulting with different healthcare practitioners. This constitutes a missed opportunity to signpost patients to appropriate clinicians and enhance understanding of different professional roles. Potential for websites to disseminate information to the public is not being maximised.

The Role of an Antimicrobial Stewardship Team in the Use of Rapid Diagnostic Testing in Acute Care: An Official Position Statement of the Society of Infectious Diseases Pharmacists

2018 ◽  
Vol 39 (4) ◽  
pp. 473-475 ◽  
Author(s):  
Brandon Hill ◽  
Navaneeth Narayanan ◽  
Elizabeth Palavecino ◽  
Katherine K. Perez ◽  
Sasha Premraj ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Antimicrobial Stewardship ◽  
Diagnostic Testing ◽  
Position Statement ◽  
Antibiotic Prescribing ◽  
Official Position ◽  
Essential Components ◽  
Reduction Strategies ◽  
Diagnostic Technologies

Rapid diagnostic technologies can assist Antimicrobial Stewardship Programs (ASPs) in achieving the goals of reducing unnecessary antimicrobial exposure and optimizing patient care. The Society of Infectious Diseases Pharmacists supports all members of the ASP team as essential components of optimal use of these technologies for management of antibiotic prescribing and cost-reduction strategies.Infect Control Hosp Epidemiol 2018;39:473–475

scholarly journals Presenting the primary care team to the public: a qualitative exploration of general practice websites

2018 ◽  
Vol 68 (668) ◽  
pp. e178-e186 ◽  
Author(s):  
Helen Anderson ◽  
Joy Adamson ◽  
Yvonne Birks
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Nurse Practitioners ◽  
Primary Healthcare ◽  
Healthcare Providers ◽  
Patient Choice ◽  
Healthcare Team ◽  
Sufficient Information ◽  
The Public ◽  
Professional Groups

BackgroundIncreasing demand and expanded primary care provision, coupled with a reduced GP workforce, present challenges for primary care. New workforce models aim to reduce GP workload by directing patients to a variety of alternative clinicians. Concurrently, the principle of patient choice in relation to healthcare providers has gained prominence. It is, therefore, necessary to provide patients with sufficient information to negotiate access to appropriate primary healthcare professionals.AimTo explore how practice websites present three exemplar healthcare professional groups (GPs, advanced nurse practitioners [ANPs], and practice nurses [PNs]) to patients and the implications for informing appropriate consultation choices.Design and settingQualitative thematic analysis of a sample of general practice websites.MethodIn total, 79 accessible websites from a metropolitan district in the north of England were thematically analysed in relation to professional representation and signposting of the three identified professional groups.ResultsInformation about each group was incomplete, inconsistent, and sometimes inaccurate across the majority of general practice websites. There was a lack of coherence and strategy in representation and direction of website users towards appropriate primary healthcare practitioners.ConclusionLimited and unclear representation of professional groups on general practice websites may have implications for the direction of patients to the wider clinical healthcare team. Patients may not have appropriate information to make choices about consulting with different healthcare practitioners. This constitutes a missed opportunity to signpost patients to appropriate clinicians and enhance understanding of different professional roles. The potential for websites to disseminate information to the public is not being maximised.

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