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Experiences and perspectives of implementing antimicrobial stewardship in five French hospitals: a qualitative study
- Source :
- International Journal of Antimicrobial Agents, International Journal of Antimicrobial Agents, Elsevier, 2018, 51 (6), pp.829-835. ⟨10.1016/j.ijantimicag.2018.01.002⟩
- Publication Year :
- 2018
- Publisher :
- HAL CCSD, 2018.
-
Abstract
- International audience; The aim of this study was to describe current antimicrobial stewardship programmes (ASPs) in France, both at policy level and at local implementation level, and to assess how ASP leaders (ASPL) worked and prioritised their activities. A qualitative study based on face-to-face semi-structured interviews with healthcare professionals responsible for ASPs across five French hospitals was conducted. Five infectious diseases specialists and one microbiologist were interviewed between April-June 2016. Stewards had dedicated time to perform ASP activities in two university-affiliated hospitals, whilst in the other hospitals (one university, one general and one semi-private), ASPLs had to balance these activities with clinical practice. Consequently, they had to adapt interventions according to their resources (IT or human). Responding to colleagues' consultation requests formed baseline work. Systematic and pro-active measures allowed for provision of unsolicited counselling, whilst direct counselling on wards required appropriate staffing. ASPLs aimed at increasing clinicians' ability to prescribe adequately and awareness of the unintended consequences of inappropriate use of antibiotics. Thus, persuasive, e.g. education, measures were preferred to coercive ones. ASPLs faced several challenges in implementing the ASP: overcoming physicians' or units' reluctance; and balancing the influence of medical hierarchy and professional boundaries. Beyond resources constraints, ASPLs' conceptions of their work, as well as contextual and cultural aspects, led them to adopt a persuasive and collaborative approach of counselling. This is the first qualitative study regarding ASPs in France exploring stewards' experiences and points of view.
- Subjects :
- 0301 basic medicine
Microbiology (medical)
030106 microbiology
Psychological intervention
Staffing
Antimicrobial stewardship
Antimicrobial resistance
Microbiology
03 medical and health sciences
0302 clinical medicine
Professional boundaries
1108 Medical Microbiology
Antibiotics
Drug Resistance, Multiple, Bacterial
Physicians
Surveys and Questionnaires
Humans
Pharmacology (medical)
030212 general & internal medicine
Practice Patterns, Physicians'
Baseline (configuration management)
Medical education
Unintended consequences
General Medicine
Hospitals
Anti-Bacterial Agents
3. Good health
Infectious Diseases
Work (electrical)
1115 Pharmacology And Pharmaceutical Sciences
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
France
Qualitative study
Psychology
Qualitative research
Subjects
Details
- Language :
- English
- ISSN :
- 09248579
- Database :
- OpenAIRE
- Journal :
- International Journal of Antimicrobial Agents, International Journal of Antimicrobial Agents, Elsevier, 2018, 51 (6), pp.829-835. ⟨10.1016/j.ijantimicag.2018.01.002⟩
- Accession number :
- edsair.doi.dedup.....23bc57ad7e1207a81bd38aff8c7079f1