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      Antimicrobial stewardship in residential aged care facilities: need and readiness assessment

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          Abstract

          Background

          Information about the feasibility, barriers and facilitators of antimicrobial stewardship (AMS) in residential aged care facilities (RACFs) has been scant. Exploring the prevailing perceptions and attitudes of key healthcare providers towards antibiotic prescribing behaviour, antibiotic resistance and AMS in the RACF setting is imperative to guide AMS interventions.

          Methods

          Semi-structured interviews and focus groups were conducted with key RACF healthcare providers until saturation of themes occurred. Participants were recruited using purposive and snowball sampling. The framework approach was applied for data analysis.

          Results

          A total of 40 nurses, 15 general practitioners (GPs) and 6 pharmacists from 12 RACFs were recruited. Five major themes emerged; perceptions of current antibiotic prescribing behaviour, perceptions of antibiotic resistance, attitude towards and understanding of AMS, perceived barriers to and facilitators of AMS implementation, and feasible AMS interventions. A higher proportion of GPs and pharmacists compared with nurses felt there was over-prescribing of antibiotics in the RACF setting. Antibiotic resistance was generally perceived as an issue for infection control rather than impacting clinical decisions. All key stakeholders were supportive of AMS implementation in RACFs; however, they recognized barriers related to workload and logistical issues. A range of practical AMS interventions were identified, with nursing-based education, aged-care specific antibiotic guidelines and regular antibiotic surveillance deemed most useful and feasible.

          Conclusions

          Areas of antibiotic over-prescribing have been identified from different healthcare providers’ perspectives. However, concern about the clinical impact of antibiotic resistance was generally lacking. Importantly, information gathered about feasibility, barriers and facilitators of various AMS interventions will provide important insights to guide development of AMS programs in the RACF setting.

          Electronic supplementary material

          The online version of this article (doi:10.1186/1471-2334-14-410) contains supplementary material, which is available to authorized users.

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          Most cited references23

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          Qualitative data analysis for applied policy research

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            Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship.

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              • Abstract: not found
              • Article: not found

              Management of multidrug-resistant organisms in health care settings, 2006.

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                Author and article information

                Contributors
                ching.lim@monash.edu
                mkunimelb@gmail.com
                Rhonda.stuart@monashhealth.org
                Kirsty.Buising@mh.org.au
                Deborahf@barwonhealth.org.au
                Noleen.Bennett@mh.org.au
                allen.cheng@monash.edu
                anton.peleg@monash.edu
                Caroline.Marshall@mh.org.au
                david.kong@monash.edu
                Journal
                BMC Infect Dis
                BMC Infect. Dis
                BMC Infectious Diseases
                BioMed Central (London )
                1471-2334
                23 July 2014
                23 July 2014
                2014
                : 14
                : 1
                : 410
                Affiliations
                [ ]Centre for Medicine Use and Safety, Monash University, 381 Royal Parade, Parkville, VIC 3052 Australia
                [ ]Department of Medicine, University of Melbourne, Royal Melbourne Hospital, 4th Floor, Clinical Sciences Building, Royal Parade, Parkville, VIC 3050 Australia
                [ ]Monash Infectious Diseases, Monash Health, Clayton, VIC Australia
                [ ]Department of Medicine, Monash University, Clayton, VIC Australia
                [ ]Victorian Infectious Diseases Service, Royal Melbourne Hospital, Parkville, VIC Australia
                [ ]Department of Infectious Diseases, St Vincent’s Hospital, Fitzroy, VIC Australia
                [ ]Department of Infectious Diseases, Barwon Health, Geelong, VIC Australia
                [ ]Victorian Healthcare Associated Infection Surveillance System Co-ordinating Centre, North Melbourne, VIC Australia
                [ ]Department of Infectious Diseases, Alfred Health, Melbourne, VIC Australia
                [ ]Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC Australia
                [ ]Department of Microbiology, Monash University, Clayton, VIC Australia
                Article
                3703
                10.1186/1471-2334-14-410
                4117949
                25055957
                6c38655d-adc4-45e0-916c-d4f9ac8e4c3b
                © Lim et al.; licensee BioMed Central Ltd. 2014

                This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 6 May 2014
                : 15 July 2014
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2014

                Infectious disease & Microbiology
                antibiotic prescribing,antibiotic resistance,antimicrobial stewardship,residential care,qualitative research

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