Implementation research for the prevention of antimicrobial resistance and healthcare-associated infections; 2017 Geneva infection prevention and control (IPC)-think tank (part 1).
Anti-Bacterial Agents
/ therapeutic use
Antimicrobial Stewardship
/ methods
Biomedical Research
Centers for Disease Control and Prevention, U.S.
Cross Infection
/ prevention & control
Drug Resistance, Bacterial
Group Processes
Health Plan Implementation
/ methods
Humans
Infection Control
/ methods
Patient Safety
United States
World Health Organization
CDC
Change
ECDC
Implementation
Infection prevention and control
Institutional
International
National
WHO
Journal
Antimicrobial resistance and infection control
ISSN: 2047-2994
Titre abrégé: Antimicrob Resist Infect Control
Pays: England
ID NLM: 101585411
Informations de publication
Date de publication:
2019
2019
Historique:
received:
14
02
2019
accepted:
23
04
2019
entrez:
5
6
2019
pubmed:
5
6
2019
medline:
28
5
2020
Statut:
epublish
Résumé
Around 5-15% of all hospital patients worldwide suffer from healthcare-associated infections (HAIs), and years of excessive antimicrobial use in human and animal medicine have created emerging antimicrobial resistance (AMR). A considerable amount of evidence-based measures have been published to address these challenges, but the largest challenge seems to be their implementation. In June 2017, a total of 42 experts convened at the Geneva IPC-Think Tank to discuss four domains in implementation science: 1) teaching implementation skills; 2) fostering implementation of IPC and antimicrobial stewardship (AMS) by policy making; 3) national/international actions to foster implementation skills; and 4) translational research bridging social sciences and clinical research in infection prevention and control (IPC) and AMR. Although neglected in the past, implementation skills have become a priority in IPC and AMS. They should now be part of any curriculum in health care, and IPC career paths should be created. Guidelines and policies should be aligned with each other and evidence-based, each document providing a section on implementing elements of IPC and AMS in patient care. International organisations should be advocates for IPC and AMS, framing them as patient safety issues and emphasizing the importance of implementation skills. Healthcare authorities at the national level should adopt a similar approach and provide legal frameworks, guidelines, and resources to allow better implementation of patient safety measures in IPC and AMS. Rather than repeating effectiveness studies in every setting, we should invest in methods to improve the implementation of evidence-based measures in different healthcare contexts. For this, we need to encourage and financially support collaborations between social sciences and clinical IPC research. Experts of the 2017 Geneva Think Tank on IPC and AMS, CDC, and WHO agreed that sustained efforts on implementation of IPC and AMS strategies are required at international, country, and hospital management levels, to provide an adequate multimodal framework that addresses (not exclusively) leadership, resources, education and training for implementing IPC and AMS. Future strategies can build on this agreement to make strategies on IPC and AMS more effective.
Sections du résumé
Background
Around 5-15% of all hospital patients worldwide suffer from healthcare-associated infections (HAIs), and years of excessive antimicrobial use in human and animal medicine have created emerging antimicrobial resistance (AMR). A considerable amount of evidence-based measures have been published to address these challenges, but the largest challenge seems to be their implementation.
Methods
In June 2017, a total of 42 experts convened at the Geneva IPC-Think Tank to discuss four domains in implementation science: 1) teaching implementation skills; 2) fostering implementation of IPC and antimicrobial stewardship (AMS) by policy making; 3) national/international actions to foster implementation skills; and 4) translational research bridging social sciences and clinical research in infection prevention and control (IPC) and AMR.
Results
Although neglected in the past, implementation skills have become a priority in IPC and AMS. They should now be part of any curriculum in health care, and IPC career paths should be created. Guidelines and policies should be aligned with each other and evidence-based, each document providing a section on implementing elements of IPC and AMS in patient care. International organisations should be advocates for IPC and AMS, framing them as patient safety issues and emphasizing the importance of implementation skills. Healthcare authorities at the national level should adopt a similar approach and provide legal frameworks, guidelines, and resources to allow better implementation of patient safety measures in IPC and AMS. Rather than repeating effectiveness studies in every setting, we should invest in methods to improve the implementation of evidence-based measures in different healthcare contexts. For this, we need to encourage and financially support collaborations between social sciences and clinical IPC research.
Conclusions
Experts of the 2017 Geneva Think Tank on IPC and AMS, CDC, and WHO agreed that sustained efforts on implementation of IPC and AMS strategies are required at international, country, and hospital management levels, to provide an adequate multimodal framework that addresses (not exclusively) leadership, resources, education and training for implementing IPC and AMS. Future strategies can build on this agreement to make strategies on IPC and AMS more effective.
Identifiants
pubmed: 31161034
doi: 10.1186/s13756-019-0527-1
pii: 527
pmc: PMC6540528
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
87Investigateurs
Antoine Andremont
(A)
Mike Bell
(M)
Michael Borg
(M)
Yehuda Carmeli
(Y)
John Conly
(J)
Philippe Eggimann
(P)
Petra Gastmeier
(P)
Lindsay Grayson
(L)
Stephan Harbarth
(S)
Marcela Hernandez
(M)
Loreen Herwaldt
(L)
Alison Holmes
(A)
John A Jernigan
(JA)
Amy Kolwaite
(A)
Karl-Heinz Krause
(KH)
Elaine Larson
(E)
Sarah Masson-Roy
(S)
Shaheen Mehtar
(S)
Marc Mendelson
(M)
Ling Moi Lin
(LM)
Andreea Moldovan
(A)
Dominique Monnet
(D)
Babacar Ndoye
(B)
Peter Nthumba
(P)
Folasade Ogunsola
(F)
Ben Park
(B)
Eli Perencevich
(E)
Matthew Samore
(M)
Wing Hong Seto
(WH)
Arjun Srinivasan
(A)
Evelina Tacconelli
(E)
Maha Talaat
(M)
Maria Virginia Villegas
(MV)
Andreas Voss
(A)
Tim Walsh
(T)
Andreas Widmer
(A)
Déclaration de conflit d'intérêts
Competing interestsThe authors declare no conflict of interest in the context of the content of this manuscript.
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