The impact of COVID-19 on antimicrobial stewardship programme implementation in hospitals: an exploration informed by the consolidated framework for implementation research. [Journal article]

Hashad, N.; Stewart, D.; Perumal, D.; Abdulrazzaq, N.; Tonna, A. P.

Abstract

The disruption of antimicrobial stewardship programmes (ASPs) caused by coronavirus disease 2019 (COVID-19) has been recognized but not explored in depth. This study used a theoretical, qualitative approach to understand the impact of COVID-19 on ASP implementation in hospitals. Semi-structured online interviews, informed by the Consolidated Framework for Implementation Research (CFIR), were conducted with ASP team members and non-members in hospitals. Participants were recruited via purposeful and snowball sampling with interviews video recorded, transcribed and analysed independently by two researchers based on mapping against CFIR constructs. Thirty-one interviews were conducted across 11 hospitals. The following themes were identified: (i) increased complexity of ASP implementation and changes in prescribing behaviour influenced by COVID-19; (ii) adaptations, networking and cosmopolitanism to enhance integration of COVID-19 management into ASP services; and (iii) adaptations and networking to support continuity of the ASP implementation process. A disruption to pre-pandemic ASP activities was reported, with complexity of COVID-19 overwhelming the healthcare system. ASP team members and services showed an ability to adapt and repurpose roles to respond to the pandemic. Interventions included developing national guidelines for treatment of patients with COVID-19 and contributing to guideline management and monitoring. A gradual restoration of ASP activities was perceived. Technological adaptations and enhancements in networking were reported as positive impacts of the pandemic. Despite the initial disruption of ASP implementation caused by the pandemic, successful adaptation and evolution of ASP services reflects the high value and adaptability of ASP implementation in hospitals in the United Arab Emirates.

Citation

HASHAD, N., STEWART, D., PERUMAL, D., ABDULRAZZAQ, N. and TONNA, A.P. 2022. The impact of COVID-19 on antimicrobial stewardship programme implementation in hospitals: an exploration informed by the consolidated framework for implementation research. Journal of hospital infection [online], 129, pages 144-152. Available from: https://doi.org/10.1016/j.jhin.2022.08.005

• Journal Article Type: Article
• Acceptance Date: Aug 15, 2022
• Online Publication Date: Aug 23, 2022
• Publication Date: Nov 30, 2022
• Deposit Date: Aug 23, 2022
• Publicly Available Date: Aug 23, 2022
• Journal: Journal of Hospital Infection
• Print ISSN: 0195-6701
• Electronic ISSN: 1532-2939
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 129
• Pages: 144-152
• DOI: https://doi.org/10.1016/j.jhin.2022.08.005
• Keywords: COVID-19; Hospital pharmacies; Antimicrobial stewardship; Pharmacist training programmes; CFIR; Implementation; Qualitative
• Public URL: https://rgu-repository.worktribe.com/output/1635346
• Additional Information: This article has been published with separate supporting information. This supporting information has been incorporated into a single file on this repository and can be found at the end of this document.