Improvement in antibacterial use in intensive care units from Argentina: A quality improvement collaborative process...

Area of Science:

• Healthcare Management
• Infectious Diseases
• Public Health

Background:

• Global rise in healthcare-associated infections and antibiotic resistance.
• Antibiotic stewardship programs (ASPs) are crucial for optimizing treatment and curbing resistance.
• Implementation of ASPs faces persistent challenges, particularly in critical care settings.

Purpose of the Study:

• To evaluate the implementation process of an antibiotic stewardship program (ASP) in intensive care units (ICUs).
• To identify challenges and successes associated with ASP implementation in Argentinian ICUs.

Main Methods:

• Qualitative study design utilizing semi-structured interviews with healthcare workers (HCWs).
• Analysis guided by Normalisation Process Theory, focusing on coherence, cognitive participation, collective action, and reflexive monitoring.
• Study conducted in eight ICUs across Argentina with 34 HCW interviews.

Main Results:

• Key challenges included insufficient human resources, lack of institutional support, and staff resistance to change.
• Partial success observed in improving antibiotic use and inter-departmental communication within ICUs.
• Inconsistent participation in improvement cycles and uncertain sustainability due to workload and training engagement issues.

Conclusions:

• Implementation of ASPs in healthcare settings faces significant, persistent challenges.
• Enhanced collaboration, workforce capacity building, and evidence-based strategies are essential for optimizing antimicrobial use.
• Addressing barriers is critical for improving patient outcomes through effective ASPs.