Emily K Black1, Lindsay MacDonald2, Heather L Neville3, Kim Abbass4, Kathryn Slayter5, Lynn Johnston6, Ingrid Sketris7. 1. , BSc(Pharm), ACPR, PharmD, is with the College of Pharmacy, Dalhousie University, Halifax, Nova Scotia. 2. , BSc(Pharm), was, at the time of this study, a student with the College of Pharmacy, Dalhousie University, Halifax, Nova Scotia. She is now a pharmacy intern at the Chaleur Regional Hospital in Bathurst, New Brunswick. 3. , BSc(Pharm), MSc, FCSHP, is with the Nova Scotia Health Authority, Halifax, Nova Scotia. 4. , BSc(Pharm), PharmD, is with the Antimicrobial Stewardship Program, Nova Scotia Health Authority, Sydney, Nova Scotia. 5. , BSc(Pharm), PharmD, FCSHP, is with the IWK Health Centre, Halifax, Nova Scotia. 6. , MD, MSc, FRCPC, is with Dalhousie University and the Department of Medicine, Nova Scotia Health Authority, Halifax, Nova Scotia. 7. , BSc(Pharm), PharmD, MPA(HSA), FCCP, FCSHP, FCAHS, is with the College of Pharmacy, Dalhousie University, Halifax, Nova Scotia.
Abstract
BACKGROUND: Antimicrobial use is the major factor in the development of antimicrobial resistance. Antimicrobial stewardship has been recommended as a strategy to improve antimicrobial use. OBJECTIVE: To learn about health care providers' perceptions of current antimicrobial use and stewardship, including barriers and facilitators to improving antimicrobial use at acute care hospitals in Nova Scotia. METHODS: This qualitative research study was conducted at acute care hospitals in Nova Scotia using focus groups and semistructured interviews. Health care providers (nurses, nurse practitioners, pharmacists, pharmacy students, and physicians) were invited to participate. Focus groups and interviews were conducted at each participant's place of employment. Interviews and focus groups were facilitated with an interview guide, audio-recorded, and transcribed verbatim. Transcripts were independently coded by 2 investigators and analyzed using thematic analysis. RESULTS: A total of 9 focus groups and 3 individual interviews were conducted between June and August 2017. Fifty-four health care professionals and trainees (24 pharmacists and pharmacy students, 14 physicians, and 16 nurses and nurse practitioners) from 5 hospitals participated. The following themes were identified: current practices, prescribing influences, access to information, collaboration and communication, resources, and antimicrobial stewardship. Within each theme, barriers and facilitators to improving antimicrobial use were identified as subthemes. CONCLUSION: Participants identified current barriers to appropriate use of antimicrobials and suggested facilitators that might improve the use of these drugs. The results of this study could be used by antimicrobial stewardship teams and decision-makers to improve antimicrobial use and stewardship initiatives throughout Nova Scotia, and may be applicable to hospitals outside the province.
BACKGROUND: Antimicrobial use is the major factor in the development of antimicrobial resistance. Antimicrobial stewardship has been recommended as a strategy to improve antimicrobial use. OBJECTIVE: To learn about health care providers' perceptions of current antimicrobial use and stewardship, including barriers and facilitators to improving antimicrobial use at acute care hospitals in Nova Scotia. METHODS: This qualitative research study was conducted at acute care hospitals in Nova Scotia using focus groups and semistructured interviews. Health care providers (nurses, nurse practitioners, pharmacists, pharmacy students, and physicians) were invited to participate. Focus groups and interviews were conducted at each participant's place of employment. Interviews and focus groups were facilitated with an interview guide, audio-recorded, and transcribed verbatim. Transcripts were independently coded by 2 investigators and analyzed using thematic analysis. RESULTS: A total of 9 focus groups and 3 individual interviews were conducted between June and August 2017. Fifty-four health care professionals and trainees (24 pharmacists and pharmacy students, 14 physicians, and 16 nurses and nurse practitioners) from 5 hospitals participated. The following themes were identified: current practices, prescribing influences, access to information, collaboration and communication, resources, and antimicrobial stewardship. Within each theme, barriers and facilitators to improving antimicrobial use were identified as subthemes. CONCLUSION: Participants identified current barriers to appropriate use of antimicrobials and suggested facilitators that might improve the use of these drugs. The results of this study could be used by antimicrobial stewardship teams and decision-makers to improve antimicrobial use and stewardship initiatives throughout Nova Scotia, and may be applicable to hospitals outside the province.
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