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Resource Stewardship

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https://www.readbyqxmd.com/read/29339297/the-experiences-and-perspectives-of-implementing-antimicrobial-stewardship-in-five-french-hospitals-a-qualitative-study
#1
Anne Perozziello, Christelle Routelous, Esmita Charani, Alice Truel, Gabriel Birgand, Yazdan Yazdanpanah, François-Xavier Lescure, Jean-Christophe Lucet
OBJECTIVE: To describe current antimicrobial stewardship program (ASP) in France, both at policy level and at local implementation level, and to assess how ASP leaders (ASPL) worked and prioritised their activities. METHODS: We conducted a qualitative study based on face-to-face semi-structured interviews with healthcare professionals responsible for ASP across five French hospitals. Five infectious disease specialists and one microbiologist were interviewed between April and June 2016...
January 12, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29337664/containment-studies-of-transgenic-mosquitoes-in-disease-endemic-countries-the-broad-concept-of-facilities-readiness
#2
M Megan Quinlan, Josephine Birungi, Mamadou B Coulibaly, Abdoulaye Diabaté, Luca Facchinelli, Wolfgang Richard Mukabana, James Mutuku Mutunga, Tony Nolan, Peter Raymond, Sékou F Traoré
Genetic strategies for large scale pest or vector control using modified insects are not yet operational in Africa, and currently rely on import of the modified strains to begin preliminary, contained studies. Early involvement of research teams from participating countries is crucial to evaluate candidate field interventions. Following the recommended phased approach for novel strategies, evaluation should begin with studies in containment facilities. Experiences to prepare facilities and build international teams for research on transgenic mosquitoes revealed some important organizing themes underlying the concept of "facilities readiness," or the point at which studies in containment may proceed, in sub-Saharan African settings...
January 2018: Vector Borne and Zoonotic Diseases
https://www.readbyqxmd.com/read/29334865/-i-never-would-have-caught-that-before-pharmacist-perceptions-of-using-clinical-decision-support-for-antimicrobial-stewardship-in-the-united-states
#3
Christopher A Giuliano, Juliann Binienda, Pramodini B Kale-Pradhan, Mohamad G Fakih
To systematically improve the appropriateness of antibiotic prescribing, antimicrobial stewardship programs have been developed. There is a paucity of literature examining how pharmacists perform antimicrobial stewardship using a clinical decision support system in a hospital setting. The purpose of this qualitative study was to develop a model exploring how pharmacists perform antimicrobial stewardship to identify areas for programmatic improvement. Semistructured interviews were conducted across a health care system until saturation of themes was reached...
January 1, 2018: Qualitative Health Research
https://www.readbyqxmd.com/read/29325400/eliminating-healthcare-associated-infections-in-iran-a-qualitative-study-to-explore-stakeholders-views
#4
Atefeh Esfandiari, Hedayat Salari, Arash Rashidian, Hossein Masoumi Asl, Abbas Rahimi Foroushani, Ali Akbari Sari
BACKGROUND: Although preventable, healthcare-associated infections (HAIs) continue to pose huge health and economic burdens on countries worldwide. Some studies have indicated the numerous causes of HAIs, but only a tiny literature exists on the multifaceted measures that can be used to address the problem. This paper presents stakeholders' opinions on measures for controlling HAIs in Iran. METHODS: We used the qualitative research method in studying the phenomenon...
April 15, 2017: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/29324181/effective-antibiotic-stewardship-in-spinal-cord-injury-challenges-and-a-way-forward
#5
Felicia Skelton, Katie Suda, Charlesnika Evans, Barbara Trautner
Context Antibiotic stewardship, defined as a multidisciplinary program to reduce the misuse of antibiotics, and in turn, antibiotic resistance, is a high priority. Persons with spinal cord injury/disorder (SCI/D) are vulnerable to receiving multiple courses of antibiotics over their lifetime given frequent healthcare exposure, and have high rates of bacterial infection with multi-drug resistant organisms. Additional challenges to evaluating appropriate use of antibiotics in this population include bacterial colonization in the urine and the differences in the presenting signs and symptoms of infection...
January 11, 2018: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29323767/high-land-use-intensity-exacerbates-shifts-in-grassland-vegetation-composition-after-severe-experimental-drought
#6
Andreas Stampfli, Juliette M G Bloor, Markus Fischer, Michaela Zeiter
Climate change projections anticipate increased frequency and intensity of drought stress but grassland responses to severe droughts and their potential to recover are poorly understood. In many grasslands, high land-use intensity has enhanced productivity and promoted resource-acquisitive species at the expense of resource-conservative ones. Such changes in plant functional composition could affect the resistance to drought and the recovery after drought of grassland ecosystems with consequences for feed productivity resilience and environmental stewardship...
January 11, 2018: Global Change Biology
https://www.readbyqxmd.com/read/29318696/an-underutilised-resource-for-antimicrobial-stewardship-a-snapshot-of-the-community-pharmacists-role-in-delayed-or-wait-and-see-antibiotic-prescribing
#7
Minyon L Avent, Jasmina Fejzic, Mieke L van Driel
OBJECTIVES: Various strategies have been implemented in primary care to address the inappropriate use of antibiotics, with varying degrees of success. One such intervention is delayed or 'wait and see' prescribing, where the prescriber indicates to wait a few days before dispensing the antibiotic. The aim of this study was to explore community pharmacists' perceptions and practice experiences with delayed antibiotic prescribing. METHODS: An online survey was advertised in two professional pharmacy organisations' e-newsletters for community and internship pharmacists in Queensland, Australia, from January to April 2016...
January 10, 2018: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29305954/clinical-use-of-the-polymyxins-the-tale-of-the-fox-and-the-cat
#8
Eric Wenzler, Kristen L Bunnell, Larry H Danziger
BACKGROUND: There is a need to identify practice patterns of polymyxin use, quantify gaps in knowledge, and recognize areas of persistent confusion. METHODS: A structured electronic survey was distributed to physicians, pharmacists, and microbiologists. Demographic information was obtained along with data regarding the availability, stewardship principles, therapeutic usage, dosing, microbiological testing, and knowledge, attitudes, and beliefs regarding the polymyxins...
January 3, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29305541/assessing-the-burden-of-c-difficile-infection-in-low-and-middle-income-countries
#9
G A Roldan, A X Cui, N R Pollock
In contrast to the significant resources invested in diagnosis and prevention of C. difficile infection (CDI) in resource-rich settings, in resource-limited settings patients with community- and hospital-acquired diarrhea may not routinely be tested for CDI. Is CDI actually less frequent or severe in resource-limited settings, or might we be missing an important opportunity to prevent CDI-related morbidity and mortality (and to promote antibiotic stewardship) in these settings? Here, we review the literature to assess the overall burden of CDI in low- and middle-income countries...
January 5, 2018: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/29300965/an-evaluation-of-the-target-treat-antibiotics-responsibly-guidance-education-tools-antibiotics-toolkit-to-improve-antimicrobial-stewardship-in-primary-care-is-it-fit-for-purpose
#10
Leah Ffion Jones, Meredith K D Hawking, Rebecca Owens, Donna Lecky, Nick A Francis, Chris Butler, Micaela Gal, Cliodna A M McNulty
Background: The TARGET (Treat Antibiotics Responsibly; Guidance, Education, Tools) Antibiotics Toolkit aims to improve antimicrobial prescribing in primary care through guidance, interactive workshops with action planning, patient facing educational and audit materials. Objective: To explore GPs', nurses' and other stakeholders' views of TARGET. Design: Mixed methods. Method: In 2014, 40 UK GP staff and 13 stakeholders participated in interviews or focus groups...
December 28, 2017: Family Practice
https://www.readbyqxmd.com/read/29282087/do-beneficiaries-views-matter-in-healthcare-purchasing-decisions-experiences-from-the-nigerian-tax-funded-health-system-and-the-formal-sector-social-health-insurance-program-of-the-national-health-insurance-scheme
#11
Ogochukwu Ibe, Ayako Honda, Enyi Etiaba, Nkoli Ezumah, Kara Hanson, Obinna Onwujekwe
BACKGROUND: Purchasing is a health financing function that involves the transfer of pooled resources to providers on behalf of a covered population. Little attention has been paid to the extent to which the views of that population  are reflected in purchasing decisions. This article explores how purchasers in two financing mechanisms: the Formal Sector Social Health Insurance Programme (FSSHIP) operating under the Nigerian National Health Insurance Scheme (NHIS), and the tax-funded health system perform their roles in light of their responsibilities to the populations...
December 28, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/29276300/multilayer-model-of-pharmacy-participation-in-the-antimicrobial-stewardship-program-at-a-large-academic-medical-center
#12
Yanina Dubrovskaya, Marco R Scipione, Justin Siegfried, Shin-Pung Jen, Vinh Pham, John Papadopoulos, Arnold Decano, Tyler Lewis, Arash Dabestani
Purpose: Leveraging pharmacy personnel resources for the purpose of antimicrobial stewardship program (ASP) operations presents a challenging task. We describe our experience integrating all pharmacists into an ASP, and evaluate the impact on ASP interventions, antimicrobial utilization, rate of selected hospital-onset infections and readmission. Summary: During a study period (January 1 to December 31, 2015), a total of 14 552 ASP-related pharmacy interventions were performed (ASP clinical pharmacotherapy specialists [CPS] n = 4025; non-ASP CPS n = 4888; hospital pharmacists n = 5639)...
October 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29247253/perspectives-on-sharing-models-and-related-resources-in-computational-biomechanics-research
#13
Ahmet Erdemir, Peter J Hunter, Gerhard A Holzapfel, Leslie M Loew, John Middleton, Christopher R Jacobs, Perumal Nithiarasu, Rainald Lohner, Guowei Wei, Beth A Winkelstein, Victor H Barocas, Farshid Guilak, Joy Ku, Jennifer L Hicks, Scott Delp, Michael Sacks, Jeffrey A Weiss, Dr Gerard A Ateshian, Steve A Maas, Andrew D McCulloch, Grace C Y Peng
The role of computational modeling for biomechanics will be increasingly prominent. In computational biomechanics, model sharing can facilitate assessment of reproducibility, and can provide an opportunity for repurposing and reuse, and a venue for medical training. The community's desire to investigate biological and biomechanical phenomena crossing multiple systems, scales, and physical domains, also motivates sharing of modeling resources as blending of models developed by domain experts is anticipated. The goal of this article is to understand current perspectives in the biomechanics community for the sharing of computational models and related resources...
December 16, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/29228940/communicating-wisely-teaching-residents-to-communicate-effectively-with-patients-and-caregivers-about-unnecessary-tests
#14
Geetha Mukerji, Adina Weinerman, Sarah Schwartz, Adelle Atkinson, Lynfa Stroud, Brian M Wong
BACKGROUND: With rising healthcare costs and a focus on quality, there is a growing need to promote resource stewardship in medical education. Physicians need to be able to communicate effectively with patients/caregivers seeking tests and treatments that are unnecessary. This study aimed to evaluate the impact of an interactive workshop on residents' knowledge of resource stewardship and communication skills when counseling patients/caregivers about requests for unnecessary testing. METHODS: Participants were 83 Internal Medicine and Pediatrics residents at the University of Toronto in 2014-15...
December 11, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29186925/indigenous-values-and-health-systems-stewardship-in-circumpolar-countries
#15
Susan Chatwood, Francois Paulette, G Ross Baker, Astrid M A Eriksen, Ketil Lenert Hansen, Heidi Eriksen, Vanessa Hiratsuka, Josée Lavoie, Wendy Lou, Ian Mauro, James Orbinski, Nathalie Pambrun, Hanna Retallack, Adalsteinn Brown
Circumpolar regions, and the nations within which they reside, have recently gained international attention because of shared and pressing public policy issues such as climate change, resource development, endangered wildlife and sovereignty disputes. In a call for national and circumpolar action on shared areas of concern, the Arctic states health ministers recently met and signed a declaration that identified shared priorities for international cooperation. Among the areas for collaboration raised, the declaration highlighted the importance of enhancing intercultural understanding, promoting culturally appropriate health care delivery and strengthening circumpolar collaboration in culturally appropriate health care delivery...
November 27, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29177489/disease-based-antimicrobial-stewardship-a-review-of-active-and-passive-approaches-to-patient-management
#16
Farnaz Foolad, Jerod L Nagel, Gregory Eschenauer, Twisha S Patel, Cynthia T Nguyen
Although new antimicrobial stewardship programmes (ASPs) often begin by targeting the reduction of antimicrobial use, an increasing focus of ASPs is to improve the management of specific infectious diseases. Disease-based antimicrobial stewardship emphasizes improving patient outcomes by optimizing antimicrobial use and increasing compliance with performance measures. Directing efforts towards the comprehensive management of specific infections allows ASPs to promote the shift in healthcare towards improving quality, safety and patient outcome metrics for specific diseases...
December 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29157244/antimicrobial-stewardship-a-qualitative-study-of-the-development-of-national-guidelines-for-antibiotic-use-in-hospitals
#17
Eli Feiring, Anne Berit Walter
BACKGROUND: As effective antibiotics are becoming a scarce resource, governmental regulation is needed to promote responsible use. Implementation of antibiotic stewardship and practice guidelines in health care facilities seems to be crucial to this effort. Empirical studies suggest, however, that guidelines have limited influence on health professionals' behavior and practice. Barriers and facilitators to guideline implementability are much studied, but little attention has been given to health professionals' perceptions of normative acceptability of guidelines as a condition for compliance...
November 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29153252/antimicrobial-stewardship-in-pediatric-post-acute-care-facilities
#18
Candace L Johnson, Meaghan Jain, Lisa Saiman, Natalie Neu
Providers in pediatric post-acute care facilities were surveyed about knowledge of and resources for antimicrobial stewardship. All agreed that antibiotics were overused in such pediatric facilities, but 60% had not implemented stewardship strategies. Lack of treatment guidelines (47%) was identified as the most common barrier to antimicrobial stewardship.
November 15, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29151013/decreasing-the-incidence-of-surgical-site-infections-following-joint-replacement-surgery
#19
Lorraine Hutzler, Jarrett Williams
OBJECTIVE: Despite the generalized use of prophylactic antibiotics in orthopaedic surgery, Surgical Site Infections (SSIs) are still a major source of morbidity, mortality, and hospital cost. This is due in part to the increasing prevalence of antibiotic resistant organisms. METHODS: A review of local epidemiology, the importance of an antibiotic stewardship program, patient optimization, and risk stratification options to reduce SSIs. RESULTS: The proportion of revisions due to infection is projected to rise rapidly over the next 25 years...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29150897/determining-best-outcomes-from-community-acquired-pneumonia-and-how-to-achieve-them
#20
REVIEW
Jane Hadfield, Lesley Bennett
Community-acquired pneumonia (CAP) is a common acute medical illness with a standard, effective treatment that was introduced before the evidenced-based medicine era. Mortality rates have improved in recent decades but improvements have been minimal when compared to other conditions such as acute coronary syndromes. The standardized approach to treatment makes CAP a target for comparative performance and outcome measures. While easy to collect, simplistic outcomes such as mortality, readmission and length of stay are difficult to interpret as they can be affected by subjective choices and health care resources...
November 17, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
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