Optimizing adherence to advice from antimicrobial stewardship audit and feedback rounds

Area of Science:

• Infectious Diseases
• Hospital Administration
• Clinical Pharmacy

Background:

• Antimicrobial stewardship programs are crucial for combating antimicrobial resistance.
• Prospective audit and feedback (PAF) is a key strategy within stewardship programs.
• Adherence to PAF recommendations can vary across different hospital settings.

Purpose of the Study:

• To compare adherence rates to antimicrobial stewardship PAF rounds between a rehabilitation service and the general acute hospital setting.
• To investigate factors influencing adherence, particularly patient referral sources.
• To identify potential models for improving stewardship program effectiveness.

Main Methods:

• Retrospective analysis of non-adherence rates to stewardship recommendations.
• Data collected from October 2014 to December 2015.
• Comparison of adherence between rehabilitation and acute hospital units, analyzing referral sources.

Main Results:

• Acute hospital medical staff exhibited significantly higher non-adherence rates (13.8%) compared to the rehabilitation service (7.6%) (p < 0.0001).
• The relative risk of non-adherence in the acute hospital setting was 1.8 (95% CI 1.3, 2.5).
• Referrals within the rehabilitation service were more frequently from medical staff (61.9% vs. 16.3%).

Conclusions:

• Adherence to antimicrobial stewardship PAF recommendations is lower in acute hospital settings compared to rehabilitation services.
• Enhanced, direct engagement between the antimicrobial stewardship team and clinical teams, as observed in the rehabilitation service, may be a key factor in improving adherence.
• This model of regular, direct engagement could be transferable to other clinical environments to bolster stewardship efforts.