Assessing hospital antibiotic stewardship program (ASP) implementation: validation of an implementation...

Area of Science:

• Implementation Science
• Health Services Research
• Infectious Diseases

Background:

• Antibiotic stewardship programs (ASPs) are vital for combating antibiotic resistance and enhancing patient care.
• A validated tool is needed to understand ASP implementation and facilitate cross-site comparisons.

Purpose of the Study:

• To develop and validate a survey instrument based on the Consolidated Framework for Implementation Research (CFIR) to assess determinants of antibiotic stewardship program implementation.
• To evaluate the psychometric properties of the developed survey.

Main Methods:

• Recruited infectious disease pharmacists and physicians from Veterans Affairs (VA) hospitals to complete a survey.
• Developed the survey based on the CFIR, assessing 22 implementation determinants across five CFIR domains.
• Conducted confirmatory factor analyses (CFA) and evaluated internal consistency (Cronbach's alpha).

Main Results:

• 150 stewards from 110 VA hospitals completed the survey.
• CFA demonstrated good fit for most CFIR constructs, with internal consistency ranging from 0.54-0.96.
• Key determinants positively perceived included Self-Efficacy, Engaging, Evidence Strength and Quality, and Relative Advantage.

Conclusions:

• The CFIR-based survey is a valid instrument for assessing determinants of antibiotic stewardship program implementation outcomes.
• This tool can assist clinical, quality improvement, and research teams in identifying implementation barriers and facilitators.
• The survey enables strategic planning and facilitates comparisons of ASP implementation across different sites.