دورية أكاديمية
أعرض في EDS

Evaluating a pilot, structured, face-to-face, antimicrobial stewardship, prospective audit-and-feedback program in emergency general surgery service in a community hospital.

التفاصيل البيبلوغرافية
العنوان: Evaluating a pilot, structured, face-to-face, antimicrobial stewardship, prospective audit-and-feedback program in emergency general surgery service in a community hospital.
المؤلفون: Chan AJ; Unity Health Toronto, Toronto, Ontario, Canada., Tsang ME; Unity Health Toronto, Toronto, Ontario, Canada.; University of Toronto, Toronto, Ontario, Canada., Langford BJ; University of Toronto, Toronto, Ontario, Canada.; Ontario Agency for Health Protection and Promotion, Toronto, Ontario, Canada.; Hotel Dieu Shaver Health and Rehabilitation Centre, St. Catharine's, Ontario, Canada., Nisenbaum R; University of Toronto, Toronto, Ontario, Canada.; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.; Applied Health Research Centre and MAP Center for Urban Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada., Wan M; Unity Health Toronto, Toronto, Ontario, Canada., Downing MA; Unity Health Toronto, Toronto, Ontario, Canada.; University of Toronto, Toronto, Ontario, Canada.
المصدر: Antimicrobial stewardship & healthcare epidemiology : ASHE [Antimicrob Steward Healthc Epidemiol] 2023 Jun 05; Vol. 3 (1), pp. e96. Date of Electronic Publication: 2023 Jun 05 (Print Publication: 2023).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Cambridge University Press Country of Publication: England NLM ID: 9918266096106676 Publication Model: eCollection Cited Medium: Internet ISSN: 2732-494X (Electronic) Linking ISSN: 2732494X NLM ISO Abbreviation: Antimicrob Steward Healthc Epidemiol Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: [Cambridge] : Cambridge University Press, [2021]-
مستخلص: Background: Prospective audit and feedback (PAF) is an established practice in critical care settings but not in surgical populations. We pilot-tested a structured face-to-face PAF program for our acute-care surgery (ACS) service.
Methods: This was a mixed-methods study. For the quantitative analysis, the structured PAF period was from August 1, 2017, to April 30, 2019. The ad hoc PAF period was from May 1, 2019, to January 31, 2021. Interrupted time-series segmented negative binomial regression analysis was used to evaluate change in antimicrobial usage measured in days of therapy per 1,000 patient days for all systemic and targeted antimicrobials. Secondary outcomes included C. difficile infections, length of stay and readmission within 30 days. Each secondary outcome was analyzed using a logistic regression or negative binomial regression model. For the qualitative analyses, all ACS surgeons and trainees from November 23, 2015, to April 30, 2019, were invited to participate in an email-based anonymous survey developed using implementation science principles. Responses were measured using counts.
Results: In total, 776 ACS patients were included in the structured PAF period and 783 patients were included in the in ad hoc PAF period. No significant changes in level or trend for antimicrobial usage were detected for all and targeted antimicrobials. Similarly, no significant differences were detected for secondary outcomes. The survey response rate was 25% (n = 10). Moreover, 50% agreed that PAF provided them with skills to use antimicrobials more judiciously, and 80% agreed that PAF improved the quality of antimicrobial treatment for their patients.
Conclusion: Structured PAF showed clinical outcomes similar to ad hoc PAF. Structured PAF was well received and was perceived as beneficial by surgical staff.
Competing Interests: All authors report no conflicts of interest relevant to this article.
(© The Author(s) 2023.)
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تواريخ الأحداث: Date Created: 20230616 Latest Revision: 20230619
رمز التحديث: 20230620
مُعرف محوري في PubMed: PMC10265735
DOI: 10.1017/ash.2023.168
PMID: 37325681
قاعدة البيانات: MEDLINE
الوصف
تدمد:2732-494X
DOI:10.1017/ash.2023.168