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Resource Stewardship

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https://www.readbyqxmd.com/read/28911324/leadership-and-governance-of-community-health-worker-programmes-at-scale-a-cross-case-analysis-of-provincial-implementation-in-south-africa
#1
Helen Schneider, Nonhlanhla Nxumalo
BACKGROUND: National community health worker (CHW) programmes are returning to favour as an integral part of primary health care systems, often on the back of pre-existing community based initiatives. There are significant challenges to the integration and support of such programmes, and they require coordination and stewardship at all levels of the health system. This paper explores the leadership and governance tasks of large-scale CHW programmes at sub-national level, through the case of national reforms to South Africa's community based sector, referred to as the Ward Based Outreach Team (WBOT) strategy...
September 15, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28903514/impact-of-an-antimicrobial-stewardship-program-on-antibiotic-use-at-a-nonfreestanding-children-s-hospital
#2
R Brigg Turner, Elena Valcarlos, Ann M Loeffler, Michael Gilbert, Dominic Chan
Background: Pediatric stewardship programs have been successful at reducing unnecessary antibiotic use. Data from nonfreestanding children's hospitals are currently limited. This study is an analysis of antibiotic use after implementation of an antimicrobial stewardship program at a community nonfreestanding children's hospital. Methods: In April 2013, an antimicrobial stewardship program that consisted of physician-group engagement and pharmacist prospective auditing and feedback was initiated...
September 1, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28887290/individual-feedback-to-reduce-inappropriate-antimicrobial-prescriptions-for-treating-acute-upper-respiratory-tract-infections-in-an-outpatient-setting-of-a-thai-university-hospital
#3
Pinyo Rattanaumpawan, Nuttagarn Chuenchom, Visanu Thamlikitkul
BACKGROUND: Excessive antimicrobial use for acute Upper Respiratory InfectionBackground Excessive antimicrobial use for acute Upper Respiratory Infections (URIs) is one of the most common problems in clinical practice. Interventions are needed to reduce antimicrobial overuse in these common infections.s (URIs) is one of the most common problems in clinical practice. Interventions are needed to reduce antimicrobial overuse in these common infections. METHODS: During a 9-month study period (June 2014-February 2015), we conducted a quasi-experimental (pre/post) study among internal medicine residents and fellows in an outpatient setting of Siriraj Hospital, Thailand...
September 5, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28874573/redefining-community-based-on-place-attachment-in-a-connected-world
#4
Georgina G Gurney, Jessica Blythe, Helen Adams, W Neil Adger, Matthew Curnock, Lucy Faulkner, Thomas James, Nadine A Marshall
The concept of community is often used in environmental policy to foster environmental stewardship and public participation, crucial prerequisites of effective management. However, prevailing conceptualizations of community based on residential location or resource use are limited with respect to their utility as surrogates for communities of shared environment-related interests, and because of the localist perspective they entail. Thus, addressing contemporary sustainability challenges, which tend to involve transnational social and environmental interactions, urgently requires additional approaches to conceptualizing community that are compatible with current globalization...
September 5, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28861524/deep-sequencing-of-rna-from-blood-and-oral-swab-samples-reveals-the-presence-of-nucleic-acid-from-a-number-of-pathogens-in-patients-with-acute-ebola-virus-disease-and-is-consistent-with-bacterial-translocation-across-the-gut
#5
Miles W Carroll, Sam Haldenby, Natasha Y Rickett, Bernadett Pályi, Isabel Garcia-Dorival, Xuan Liu, Gary Barker, Joseph Akoi Bore, Fara Raymond Koundouno, E Diane Williamson, Thomas R Laws, Romy Kerber, Daouda Sissoko, Nóra Magyar, Antonino Di Caro, Mirella Biava, Tom E Fletcher, Armand Sprecher, Lisa F P Ng, Laurent Rénia, N'faly Magassouba, Stephan Günther, Roman Wölfel, Kilian Stoecker, David A Matthews, Julian A Hiscox
In this study, samples from the 2013-2016 West African Ebola virus outbreak from patients in Guinea with Ebola virus disease (EVD) were analyzed to discover and classify what other pathogens were present. Throat swabs were taken from deceased EVD patients, and peripheral blood samples were analyzed that had been taken from patients when they presented at the treatment center with acute illness. High-throughput RNA sequencing (RNA-seq) and bioinformatics were used to identify the potential microorganisms. This approach confirmed Ebola virus (EBOV) in all samples from patients diagnosed as acute positive for the virus by quantitative reverse transcription-PCR in deployed field laboratories...
July 2017: MSphere
https://www.readbyqxmd.com/read/28853035/expanding-antimicrobial-stewardship-to-urgent-care-centers-through-a-pharmacist-led-culture-follow-up-program
#6
Lisa E Dumkow, Thomas S Beuschel, Kasey L Brandt
INTRODUCTION: Urgent care centers represent a high-volume outpatient setting where antibiotics are prescribed frequently but resources for antimicrobial stewardship may be scarce. In 2015, our pharmacist-led Emergency Department (ED) culture follow-up program was expanded to include two urgent care (UC) sites within the same health system. The UC program is conducted by ED and infectious diseases clinical pharmacists as well as PGY1 pharmacy residents using a collaborative practice agreement (CPA)...
August 29, 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/28851265/post-operative-fever-in-orthopaedic-surgery-how-effective-is-the-fever-workup
#7
Blair Ashley, David A Spiegel, Patrick Cahill, Divya Talwar, Keith D Baldwin
BACKGROUND: Defining the appropriate threshold at which to initiate a fever workup is imperative to promote patient safety, appropriate resource utilization, and antibiotic stewardship. Our group performed a systematic review of the available literature on perioperative fever (POF) workups in orthopaedic patients to evaluate the frequency, timing and utility of blood cultures (BC) and other investigations in the POF workup, to determine the clinical relevance of any infections and to evaluate their cost effectiveness...
September 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28842518/formalization-of-an-antimicrobial-stewardship-program-in-a-small-community-hospital
#8
Alexa R Lockwood, Nicole S Bolton, Mark D Winton, Jean T Carter
PURPOSE: Results of a study to formalize an antimicrobial stewardship program (ASP) in a small community hospital are presented. METHODS: The formalization process began with a gap analysis of the hospital's antimicrobial services, followed by the development of a fully integrated, multipharmacist ASP. The impact was studied with an institutional review board-approved study design. Retrospective pre-ASP data were pulled from March 1 to June 30, 2012 and 2013 patient records; prospective post-ASP data were collected for March 1 to June 30, 2015...
September 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28839314/reusing-dialyzer-in-low-income-countries-a-good-cost-saving-tactic-with-complex-ethics
#9
Murtaza Fakhruddin Dhrolia, Salman Imtiaz, Ruqaya Qureshi, Aasim Ahmed
Despite almost universal practice of dialyzer reuse from the earliest days of haemodialysis, reusing dialyzer always remains a controversial issue and several ethical concerns have been raised. Some of the important are safety of reuse over single use, informed consent of the patient, conflict of interest on the part of physician or manufacturer, fiscal responsibility and environmental stewardship. Indeed, at the beginning of this century, there was a drastic shift of practice in favour of single use in developed countries due to availability of biocompatible haemodialyzers, at favourable price...
August 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28802758/impact-of-rapid-identification-of-staphylococcus-aureus-bloodstream-infection-without-antimicrobial-stewardship-intervention-on-antibiotic-optimization-and-clinical-outcomes
#10
R Brigg Turner, Karineh Lalikian, Madeline Fry, Jacqueline Schwartz, Dominic Chan, Regina Won
Few studies have evaluated the clinical impact of polymerase chain reaction (PCR) for Staphylococcus aureus bloodstream infections in resource-limited settings that lack direct antimicrobial stewardship intervention. This retrospective cohort study compared patients with standard microbiological identification (n=343) to those with additional identification by (PCR) (n=130). Time to initiation of optimal therapy was similar between groups but substantially shorter in the PCR group for those infected with methicillin susceptible S...
July 8, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28781151/2016-guideline-strategies-for-the-use-of%C3%A2-antifungal-agents-in-patients-with-hematological-malignancies-or-hematopoietic-stem-cell-transplantation-recipients-in-taiwan
#11
REVIEW
Bor-Sheng Ko, Wei-Ting Chen, Hsiang-Chi Kung, Un-In Wu, Jih-Luh Tang, Ming Yao, Yee-Chun Chen, Hwei-Fang Tien, Shan-Chwen Chang, Yin-Ching Chuang, Dong-Tsamn Lin
The Infectious Diseases Society of Taiwan (IDST), the Hematology Society of Taiwan, the Taiwan Society of Blood and Marrow Transplantation, Medical Foundation in Memory of Dr. Deh-Lin Cheng, Foundation of Professor Wei-Chuan Hsieh for Infectious Diseases Research and Education, and CY Lee's Research Foundation for Pediatric Infectious Diseases and Vaccines cooperatively published this guideline for the use of antifungal agents in hematological patients with invasive fungal diseases (IFDs) in Taiwan. The guideline is the first one endorsed by IDST focusing on selection of antifungal strategies, including prophylaxis, empirical (or symptom-driven) and pre-emptive (or diagnostic-driven) strategy...
July 25, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28758612/incidence-of-extended-spectrum-%C3%AE-lactamase-esbl-producing-escherichia-coli-and-klebsiella-infections-in-the-united-states-a-systematic-literature-review
#12
Jennifer McDanel, Marin Schweizer, Victoria Crabb, Richard Nelson, Matthew Samore, Karim Khader, Amy E Blevins, Daniel Diekema, Hsiu-Yin Chiang, Rajeshwari Nair, Eli Perencevich
BACKGROUND Despite a reported worldwide increase, the incidence of extended-spectrum β-lactamase (ESBL) Escherichia coli and Klebsiella infections in the United States is unknown. Understanding the incidence and trends of ESBL infections will aid in directing research and prevention efforts. OBJECTIVE To perform a literature review to identify the incidence of ESBL-producing E. coli and Klebsiella infections in the United States. DESIGN Systematic literature review. METHODS MEDLINE via Ovid, CINAHL, Cochrane library, NHS Economic Evaluation Database, Web of Science, and Scopus were searched for multicenter (≥2 sites), US studies published between 2000 and 2015 that evaluated the incidence of ESBL-E...
October 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28697159/outpatient-parenteral-antimicrobial-therapy-and-judicious-use-of-pediatric-emergency-resources
#13
Michael Xu, Quynh Doan
BACKGROUND: Pediatric returns to the emergency department (RTED) vary between 3% and 13% of the total ED volume of visits. However, the incidence and contribution of scheduled RTED on pediatric emergency department (PED) utilization is less clear. Antimicrobial stewardship programs on inpatient wards have been shown to improve judicious use of outpatient parenteral antimicrobial therapy (OPAT) in upon discharge. The implementation of such programs in PEDs has yet to be reported. The objectives of this study are to quantify the burden of scheduled RTED for OPAT on PED utilization and to examine how frequently OPAT use are supported by published practice standards for 3 common pediatric infections-cellulitis, pneumonia, and urinary tract infections...
July 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28689031/re-defining-the-characteristics-of-environmental-volunteering-creating-a-typology-of-community-scale-green-infrastructure
#14
Gemma Jerome, Ian Mell, Dave Shaw
One way to engage people with green infrastructure (GI) is as environmental volunteers. Previous studies explored the nature of such groups/projects in terms of the benefits they deliver such as their impact on levels of social capital within a pre-defined community. However, existing literature contributes little to our understanding of the composition, characteristics and mechanisms used to form and maintain these groups. As such, it is difficult to establish the influencing factors determining the capacity of a group to sustain its provision over time...
October 2017: Environmental Research
https://www.readbyqxmd.com/read/28678309/fenticonazole-an-effective-topical-treatment-for-superficial-mycoses-as-the-first-step-of-antifungal-stewardship-program
#15
F Tumietto, L Giacomelli
The resistance of microorganisms to antimicrobial drugs is a major issue for public health, with important consequences in terms of morbidity, mortality and resource use. The phenomenon is so serious that in some areas of the world resistant strains to all available drugs have been selected. Many conditions may result in the development of resistance: they include the indiscriminate or inappropriate (e.g., for viral infection or colonization) use of antibiotics, the excessive duration of the prescribed treatment regimens, as well as inadequate dosing or administration routes...
June 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28662451/a-spatial-framework-for-targeting-urban-planning-for-pollinators-and-people-with-local-stakeholders-a-route-to-healthy-blossoming-communities
#16
Chloe C Bellamy, Alexander P N van der Jagt, Shelley Barbour, Mike Smith, Darren Moseley
Pollinators such as bees and hoverflies are essential components of an urban ecosystem, supporting and contributing to the biodiversity, functioning, resilience and visual amenity of green infrastructure. Their urban habitats also deliver health and well-being benefits to society, by providing important opportunities for accessing nature nearby to the homes of a growing majority of people living in towns and cities. However, many pollinator species are in decline, and the loss, degradation and fragmentation of natural habitats are some of the key drivers of this change...
October 2017: Environmental Research
https://www.readbyqxmd.com/read/28655372/antibiotic-stewardship-new-frontier-familiar-journey
#17
Caren McHenry Martin
Recent changes in regulations by the Centers for Medicare & Medicaid Services require long-term care facilities to meet specific requirements on antibiotic stewardship, promoting the appropriate use of antibiotics and antimicrobials. The goal is to improve patient outcomes and decrease the spread of infections caused by multi-drug-resistant organisms. Consultant pharmacists can help facility personnel implement policies and procedures for effective antibiotic stewardship, assist prescribers and facility staff in understanding how to use the facility's antibiogram, find appropriate resources, and provide facility personnel with feedback on their antimicrobial stewardship efforts...
May 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28654801/hybrid-governance-of-aquaculture-opportunities-and-challenges
#18
Joanna Vince, Marcus Haward
The development of third party assessment and certification of fisheries and aquaculture has provided new forms of governance in sectors that were traditionally dominated by state based regulation. Emerging market based approaches are driven by shareholder expectations as well as commitment to corporate social responsibility, whereas community engagement is increasingly centered on the questions of social license to operate. Third party assessment and certification links state, market and community into an interesting and challenging hybrid form of governance...
June 24, 2017: Journal of Environmental Management
https://www.readbyqxmd.com/read/28642146/is-antimicrobial-stewardship-cost-effective-a-narrative-review-of-the-evidence
#19
REVIEW
N R Naylor, N Zhu, M Hulscher, A Holmes, R Ahmad, J V Robotham
AIMS: This narrative review aimed to collate recent evidence on the cost-effectiveness and cost-benefit of antimicrobial stewardship (AMS) programmes, to address the question 'is AMS cost-effective?', while providing resources and guidance for future research in this area. SOURCES: PubMed was searched for studies assessing the cost-effectiveness, cost-utility or cost-benefit of AMS interventions in humans, published from January 2000 to March 2017, with no setting inclusion/exclusion criteria specified...
June 20, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28595316/developing-a-local-antimicrobial-resistance-action-plan-the-cornwall-one-health-antimicrobial-resistance-group
#20
Neil Powell, Iain Davidson, Phillip Yelling, Andrew Collinson, Adam Pollard, Lisa Johnson, Nick Gibson, Jennifer Taylor, Kathryn Wisner, William Gaze, Janice South, Diane Ashiru-Oredope
Objectives: The UK Five Year Antimicrobial Resistance (AMR) Strategy was published in September 2013 and recommended a One Health approach emphasizing the importance of collaboration to tackle AMR. We describe the inauguration of what we believe to be the first regional One Health group established in the UK. The purpose of the group was to ensure the implementation of a coordinated Cornwall-wide response to the UK AMR Strategy and we describe the outputs of the group to date. Methods: The Cornwall Antimicrobial Resistance Group was set up as a sub-group of the Health & Wellbeing Board's Health Protection Committee...
September 1, 2017: Journal of Antimicrobial Chemotherapy
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