Enhancing antimicrobial surveillance in hospitals in England: a RAND-modified Delphi.
Journal
JAC-antimicrobial resistance
ISSN: 2632-1823
Titre abrégé: JAC Antimicrob Resist
Pays: England
ID NLM: 101765283
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
received:
14
04
2022
accepted:
12
08
2022
entrez:
15
9
2022
pubmed:
16
9
2022
medline:
16
9
2022
Statut:
epublish
Résumé
Optimizing antimicrobial use (AMU) is key to reducing antimicrobial-resistant infections, but current AMU monitoring in hospital provides limited insights for quality improvement. To understand stakeholders' priorities for developing national AMU surveillance in English hospitals to serve the needs of national policy makers and front-line practitioners. Characteristics of existing AMU surveillance systems were identified from a previous systematic review and categorized by the Acceptability, Practicability, Effectiveness, Affordability, Side-effects and Equity (APEASE) criteria. Stakeholders prioritized characteristics using a two-round RAND-modified Delphi (rating round 1, telephone panel discussion, rating round 2). Findings informed the design of a framework used to assess the extent to which existing surveillance approaches meet stakeholders' needs. Between 17/09/19 and 01/11/19, 24 stakeholders with national and local roles related to AMU prioritized 23 characteristics of AMU surveillance describing: resource for surveillance, data collection, data availability and pathways to translate information from surveillance into practice. No existing surveillance approaches demonstrated all prioritized characteristics. The most common limitation was failure to facilitate clinician engagement with AMU through delays in data access and/or limited availability of disaggregated metrics of prescribing. Current surveillance delivers national public health priorities but improving stewardship demands patient-level data linked to clinical outcomes. This study offers a framework to develop current surveillance to meet the needs of local stakeholders in England. Increased investment in data infrastructure and training is essential to make information held within electronic systems available to front-line clinicians to facilitate quality improvement.
Sections du résumé
Background
UNASSIGNED
Optimizing antimicrobial use (AMU) is key to reducing antimicrobial-resistant infections, but current AMU monitoring in hospital provides limited insights for quality improvement.
Objectives
UNASSIGNED
To understand stakeholders' priorities for developing national AMU surveillance in English hospitals to serve the needs of national policy makers and front-line practitioners.
Methods
UNASSIGNED
Characteristics of existing AMU surveillance systems were identified from a previous systematic review and categorized by the Acceptability, Practicability, Effectiveness, Affordability, Side-effects and Equity (APEASE) criteria. Stakeholders prioritized characteristics using a two-round RAND-modified Delphi (rating round 1, telephone panel discussion, rating round 2). Findings informed the design of a framework used to assess the extent to which existing surveillance approaches meet stakeholders' needs.
Results
UNASSIGNED
Between 17/09/19 and 01/11/19, 24 stakeholders with national and local roles related to AMU prioritized 23 characteristics of AMU surveillance describing: resource for surveillance, data collection, data availability and pathways to translate information from surveillance into practice. No existing surveillance approaches demonstrated all prioritized characteristics. The most common limitation was failure to facilitate clinician engagement with AMU through delays in data access and/or limited availability of disaggregated metrics of prescribing.
Conclusions
UNASSIGNED
Current surveillance delivers national public health priorities but improving stewardship demands patient-level data linked to clinical outcomes. This study offers a framework to develop current surveillance to meet the needs of local stakeholders in England. Increased investment in data infrastructure and training is essential to make information held within electronic systems available to front-line clinicians to facilitate quality improvement.
Identifiants
pubmed: 36105825
doi: 10.1093/jacamr/dlac092
pii: dlac092
pmc: PMC9465639
doi:
Types de publication
Journal Article
Langues
eng
Pagination
dlac092Informations de copyright
© The Author(s) 2022. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.
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