Development of a web-based application to improve data collection of antimicrobial utilization in the public health care system in South Africa

Abstract

Objective: Determining antimicrobial utilization patterns in hospitals can be a challenge given personnel and resource constraints with paper-based systems. A web-based application (APP) was developed in South Africa to address this, building on a recent point prevalence survey (PPS) using a paper-based system. Consequently, there was a need to test and evaluate the ease of use of a newly developed app and potential time saving versus paper-based methods for PPS. The findings can be used to further refine the APP. Methods: The developed app was tested in a large academic public hospital in a PPS in South Africa. During data collection, the app was evaluated for functionality on 35 variables and subsequently refined. After data collection, the app was evaluated in terms of its time-saving potential and ease of use. Results: 181 patient's files were surveyed across 13 wards in the hospital, with the antimicrobial usage findings similar to the previous paper-based study in the same hospital. The median age for males was 45.5 years and 42 years for females. Overall 80 out of 181 (44%) patients received antibiotics. Whilst 38% (12 out of 31) of patients in the adult surgical ward received antimicrobials, the prevalence was the highest (78%) in the pediatric medical wards. All the data collectors were confident in using the app after training and found the tool is not complex at all to use. In addition, the time taken to plan for the study and to collect data was considerably reduced. Reduced time spent in data collection and analysis is important for timely instigation of quality improvement programs in resource limited settings. Conclusions: All data collectors would recommend the app for future PPSs. Several concerns with data entry were identified, which have now been addressed. The app development has been successful and is now being deployed across South Africa as part of a national PPS as well as wider.

Challenges and Innovations Brought about by the COVID-19 Pandemic Regarding Medical and Pharmacy Education Especially in Africa and Implications for the Future

“…The pandemic, including the development of innovative management and treatment approaches [ 43 ] coupled with innovative approaches to teaching, has also provided an opportunity for African universities to showcase their skills to attract future investment. We have already seen apps being developed in South Africa to rapidly assess the use of antimicrobials among patients in hospitals given current concerns [ 17 , 110 , 139 , 140 ], with such approaches likely to grow, building on the greater use of technologies to manage patient care across Africa and the wider world [ 43 , 75 , 141 , 142 , 143 ].…”

A national, multicentre web-based point prevalence survey of antimicrobial use in community healthcare centres across South Africa and the implications

“…This was a PPS study to determine antimicrobial utilization patterns among 18 CHCs across South Africa using a webbased application (APP) [27]. We have used this approach before to assess current antimicrobial utilization patterns among the pediatric and adult populations in public sector hospitals in South Africa [29,31].…”

“…We are aware of a number of studies conducted across South Africa investigating the utilization of antimicrobials in ambulatory care [22][23][24][25] combined with studies assessing total antimicrobial utilization in South Africa [26]. Alongside this, point prevalence surveys (PPS) have been undertaken among hospitals in South Africa to document their current utilization patterns [27][28][29][30]. However, we were unaware of any study undertaken to date to assess current antimicrobial prescribing within CHCs in South Africa.…”

Antimicrobial Stewardship Activities in Public Healthcare Facilities in South Africa: A Baseline for Future Direction

“…Detail on the data collection for Phase 1 has been described previously [ 33 ]. In summary, a web-based application, adapted from a point prevalence study [ 100 , 101 ], enabled participants to complete an English questionnaire via any mobile or desktop device with internet connectivity. The Framework guidelines served as the basis for the questionnaire, which related to three critical governance structures: IPC, PTC and AMS, with AMS being the focus of this paper.…”