Complex Hospital-Based Electronic Prescribing-Based Intervention to Support Antimicrobial Stewardship: Qualitative...

Area of Science:

• Healthcare Management
• Infectious Disease Control
• Public Health

Background:

• Antimicrobial resistance (AMR) poses a significant global public health threat.
• Effective antimicrobial stewardship (AMS) programs are crucial for combating AMR in hospital settings.

Purpose of the Study:

• To investigate the challenges in developing and implementing a complex intervention aimed at improving hospital AMS.
• To identify facilitators and barriers to the effective use of AMS interventions.

Main Methods:

• Qualitative evaluation of a multi-component AMS intervention in an English hospital.
• Interviews with 25 healthcare professionals (prescribers, nurses, pharmacists, microbiologists) at two time points.
• Observations of ward rounds to understand AMS practices in real-world settings.

Main Results:

• Intervention adoption and impact were challenging to track due to competing hospital pressures.
• Behavioral and educational components were often delivered inconsistently.
• Participatory design addressed typical use cases but not all real-world variations and edge cases.

Conclusions:

• User-focused design enhances the acceptance and use of complex AMS interventions.
• Not all implementation barriers and requirements can be foreseen or tested prior to full deployment.