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Specifying an implementation framework for Veterans Affairs antimicrobial stewardship programmes: using a factor

Ann F Chou1,2, Christopher J Graber2,3, Yue Zhang4,5

  • 1Department of Family and Preventive Medicine, College of Medicine, University of Oklahoma, 900 NE 10th St., Oklahoma City, OK 73104, USA.

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This summary is machine-generated.

Implementing antimicrobial stewardship programmes (ASPs) is challenging. This study identified key organizational factors, including evidence, context, and facilitation, to improve ASP design and implementation for better patient safety.

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Area of Science:

  • Health Services Research
  • Implementation Science
  • Antimicrobial Resistance

Background:

  • Inappropriate antibiotic use is a significant patient safety concern.
  • Antimicrobial stewardship programmes (ASPs) aim to optimize antibiotic use and improve patient outcomes.
  • Implementing ASPs presents organizational challenges.

Purpose of the Study:

  • To identify organizational factors facilitating the design, development, and implementation of ASPs.
  • To utilize the Promoting Action on Research Implementation in Health Services (PARiHS) framework.
  • To provide an analytical model for optimizing ASP performance through existing organizational processes.

Main Methods:

  • Classified organizational variables into PARiHS domains: evidence, context, and facilitation.
  • Conducted exploratory factor analyses on data from 130 Veterans Affairs facilities.
  • Calculated Cronbach's alphas to assess reliability of identified factors.

Main Results:

  • Identified 32 factors across the three PARiHS domains.
  • Evidence domain included guidelines and clinical pathways.
  • Context domain comprised receptive context, team functioning, and evaluation/feedback.
  • Facilitation domain included facilitator roles, tasks, skills, and training.

Conclusions:

  • A model was developed mapping survey data onto PARiHS domains to facilitate ASP uptake.
  • The model focuses on mutable factors for optimizing antimicrobial use.
  • Leveraging existing organizational processes can potentially enhance ASP performance.