Building an antimicrobial stewardship model for a public-sector hospital: a pre-implementation study

Area of Science:

• Public Health
• Infectious Diseases
• Healthcare Management

Background:

• Antimicrobial resistance (AMR) poses a significant global health threat, increasing mortality, morbidity, and healthcare expenses.
• Antimicrobial stewardship (AMS) programs are crucial for promoting rational antimicrobial use.
• Effective AMS programs require tailoring to facility resources and existing structures.

Purpose of the Study:

• To evaluate the preparedness of a tertiary healthcare facility and its staff for implementing an antimicrobial stewardship program (ASP).
• To identify existing strengths, weaknesses, opportunities, and threats (SWOT) related to AMR and AMS implementation.
• To establish a baseline for future improvements in ASP initiatives.

Main Methods:

• A pre-implementation phase SWOT analysis was conducted.
• A questionnaire assessed healthcare professionals' (HCPs) attitudes towards AMR and AMS.
• A situational analysis evaluated the facility's readiness for an ASP.

Main Results:

• A low response rate (1.0%) from 3100 HCPs was observed, with 32 participants (2 pharmacists, 16 clinicians, 14 nurses).
• Over 90% of participants recognized AMR as a problem in South African hospitals and their facility.
• Strengths included established AMS committees and IT systems, while weaknesses involved limited AMS activities and poor HCP participation.

Conclusions:

• A pre-implementation phase is vital for identifying and addressing gaps before launching an ASP.
• This phase provides a baseline for measuring the impact of the implemented ASP.
• Addressing identified weaknesses in activities and participation is crucial for successful ASP implementation.