Collaborative Antimicrobial Stewardship

Palavecino, Elizabeth; Williamson, John; Ohl, Christopher

doi:10.1016/j.idc.2019.10.006

Cited by 20 publications

(14 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some interventions identified were public awareness campaigns [26], antimicrobial guidelines [30], professional regulation [31], restricted reimbursement [32], pay for performance, and prescription requirements [32,33]. Collaborative practice and recommen- dation acceptance by the clinical provider is also important for an antibiotic stewardship program [34] and for collaborative approaches to appropriate antimicrobial use [35]. Logan's study in 28 hospitals showed that collaborative practice in antibiotic stewardship increased days of therapy (DOT) per 1,000 patient-days of broad-spectrum antibiotics reduction from 1%-2.5% to 5%-10% [36].…”

Section: Discussionmentioning

confidence: 99%

Antibiotic stewardship knowledge and belief differences among healthcare professionals in hospitals: A survey study

Herawati

Jaelani²,

Wijono

et al. 2021

Heliyon

View full text Add to dashboard Cite

Background: Collaborative practice in healthcare has been recommended to improve the quality of antimicrobial stewardship interventions, a behavioral change in antimicrobial use. Insufficient knowledge regarding antibiotic resistance, the fear of complications from infections, and how providers perceive antibiotic use and resistance are likely to influence prescribing behavior. This study's objective was to identify the knowledge and belief healthcare professionals' differences about antibiotic stewardship. Methods: This cross-sectional survey study of three hospitals in the East Java province, Indonesia utilized a 43item questionnaire to assess antimicrobial stewardship knowledge and belief. There were 12 knowledge questions (total possible score: 12) and 31 belief questions (total possible score: 155). The Kuder Richardson 20 and Cronbach alpha values of the questionnaire were 0.54 and 0.92, respectively. Results: Out of the 257 respondents, 19% (48/257) had a low scores of knowledge, and 39% (101/257) had low scores on belief about antibiotic stewardship (101/257). Most midwives had a low scores on knowledge (25/61) and low scores on belief (46/61). Respondents with high scores on belief were 17% (10/59) physicians, 15% (4/ 27) pharmacists, 8% (5/65) nurses, and 3% (2/61) midwives. Conclusion: Among healthcare professionals, knowledge and belief differences concerning antibiotic stewardship vary widely. These differences will affect their capability, behavior, and contribution to the healthcare team collaboration and performance. Further studies are needed to evaluate the correlation between the level of interprofessional collaboration and the quality of the antibiotic stewardship implementation.

show abstract

Section: Discussionmentioning

confidence: 99%

Antibiotic stewardship knowledge and belief differences among healthcare professionals in hospitals: A survey study

Herawati

Jaelani²,

Wijono

et al. 2021

Heliyon

View full text Add to dashboard Cite

show abstract

“…Reduced turn-around time (TAT) in either identification or susceptibility information is not sufficient to indicate the improved utility of a test, though it is an important component [ 101 ]. Other parameters include the sensitivity, specificity, type of result yielded and the confidence of the relevant clinician acting upon the result [ 102 ].…”

Section: How Should the Clinical Utility Of Novel Rapid Diagnostics Be Evaluated?mentioning

confidence: 99%

“…There is a paucity of high-quality evidence in this field, though there are numerous quasi-studies that have evaluated AMS outcomes with several incorporating a selection of clinical or process outcomes [ 45 , 103 , 104 ]. The most consistent, though not universal finding, has been that rapid technologies alone do no translate even to better AMS outcomes, let alone improved clinical outcomes, without also embedding customised AMS support strategies and this is reflected in the Infectious Diseases Society of America (IDSA) guidelines [ 45 , 52 , 101 , 105 , 106 ].…”

Section: How Should the Clinical Utility Of Novel Rapid Diagnostics Be Evaluated?mentioning

confidence: 99%

New Microbiological Techniques for the Diagnosis of Bacterial Infections and Sepsis in ICU Including Point of Care

Peri

Stewart

Hume

et al. 2021

Curr Infect Dis Rep

View full text Add to dashboard Cite

Purpose of Review The aim of this article is to review current and emerging microbiological techniques that support the rapid diagnosis of bacterial infections in critically ill patients, including their performance, strengths and pitfalls, as well as available data evaluating their clinical impact. Recent Findings Bacterial infections and sepsis are responsible for significant morbidity and mortality in patients admitted to the intensive care unit and their management is further complicated by the increase in the global burden of antimicrobial resistance. In this setting, new diagnostic methods able to overcome the limits of traditional microbiology in terms of turn-around time and accuracy are highly warranted. We discuss the following broad themes: optimisation of existing culture-based methodologies, rapid antigen detection, nucleic acid detection (including multiplex PCR assays and microarrays), sepsis biomarkers, novel methods of pathogen detection (e.g. T2 magnetic resonance) and susceptibility testing (e.g. morphokinetic cellular analysis) and the application of direct metagenomics on clinical samples. The assessment of the host response through new “omics” technologies might also aid in early diagnosis of infections, as well as define non-infectious inflammatory states. Summary Despite being a promising field, there is still scarce evidence about the real-life impact of these assays on patient management. A common finding of available studies is that the performance of rapid diagnostic strategies highly depends on whether they are integrated within active antimicrobial stewardship programs. Assessing the impact of these emerging diagnostic methods through patient-centred clinical outcomes is a complex challenge for which large and well-designed studies are awaited.

show abstract

“…The DMT approach leverages a multi-disciplinary health care team, which includes the patient and medical professionals that works collaboratively to make team-based decisions with the intent to derive at an accurate and timely diagnosis. For example, the DMT approach has been useful in the timely and accurate diagnosis of active infections, permitting judicious administration of antibiotics [ 15 , 17 ]. For this example, The DMT team can include clinicians, laboratory professionals, pharmacists and infectious disease specialists, among others.…”

Section: Use Of the Diagnostic Management Team Approach To Support Diagnostic Excellencementioning

confidence: 99%

Bringing the clinical laboratory into the strategy to advance diagnostic excellence

et al. 2021

View full text Add to dashboard Cite

ObjectivesClinical laboratory testing provides essential data for making medical diagnoses. Generating accurate and timely test results clearly communicated to the treating clinician, and ultimately the patient, is a critical component that supports diagnostic excellence. On the other hand, failure to achieve this can lead to diagnostic errors that manifest in missed, delayed and wrong diagnoses.ContentInnovations that support diagnostic excellence address: 1) test utilization, 2) leveraging clinical and laboratory data, 3) promoting the use of credible information resources, 4) enhancing communication among laboratory professionals, health care providers and the patient, and 5) advancing the use of diagnostic management teams. Integrating evidence-based laboratory and patient-care quality management approaches may provide a strategy to support diagnostic excellence. Professional societies, government agencies, and healthcare systems are actively engaged in efforts to advance diagnostic excellence. Leveraging clinical laboratory capabilities within a healthcare system can measurably improve the diagnostic process and reduce diagnostic errors.SummaryAn expanded quality management approach that builds on existing processes and measures can promote diagnostic excellence and provide a pathway to transition innovative concepts to practice.OutlookThere are increasing opportunities for clinical laboratory professionals and organizations to be part of a strategy to improve diagnoses.

show abstract

Collaborative Antimicrobial Stewardship

Cited by 20 publications

References 34 publications

Antibiotic stewardship knowledge and belief differences among healthcare professionals in hospitals: A survey study

Antibiotic stewardship knowledge and belief differences among healthcare professionals in hospitals: A survey study

New Microbiological Techniques for the Diagnosis of Bacterial Infections and Sepsis in ICU Including Point of Care

Bringing the clinical laboratory into the strategy to advance diagnostic excellence

Contact Info

Product

Resources

About