Implementation of antimicrobial stewardship certification program and its impact on low-resource settings

Area of Science:

• Infectious Diseases
• Public Health
• Pharmacy Practice

Background:

• Antimicrobial resistance (AMR) poses a significant global health challenge, necessitating robust antimicrobial stewardship (AMS) programs.
• Access to infectious diseases expertise is often limited in rural and smaller healthcare facilities, such as critical access hospitals (CAHs) and skilled nursing facilities (SNFs).
• Pharmacists in these low-resource settings represent a potential key resource for implementing AMS initiatives.

Purpose of the Study:

• To assess the feasibility and impact of providing free antimicrobial stewardship (AMS) certification to pharmacists in low-resource settings.
• To evaluate the role of state-supported training programs in enhancing AMS capacity in rural healthcare facilities.
• To determine the effectiveness of utilizing existing pharmacy personnel to address AMS challenges in underserved areas.

Main Methods:

• A collaborative program between the North Dakota Department of Health and Human Services and North Dakota State University offered free AMS certification via the Society of Infectious Diseases Pharmacists (SIDP).
• Eighty-five pharmacists serving CAHs, SNFs, or willing to support these facilities were selected from 113 applicants between 2018 and 2022 (excluding 2020).
• Program completion and the development and implementation of AMS interventions were tracked over four years.

Main Results:

• Fifty-four percent of participating pharmacists successfully completed the AMS certification program.
• A significant proportion of completers (54%) developed and implemented AMS interventions within their facilities.
• An additional 32% had AMS interventions in progress at the time of assessment, indicating ongoing engagement.

Conclusions:

• Providing free AMS certification to pharmacists in low-resource settings is a viable strategy to build capacity for antimicrobial stewardship.
• This initiative demonstrates a cost-effective use of state resources to improve AMS practices in underserved rural areas.
• Empowering pharmacists through specialized training can effectively address the challenge of antimicrobial resistance in facilities with limited access to infectious diseases specialists.