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Antimicrobial stewardship programme implementation in the UAE: perspectives of key stakeholders using consolidated framework for implementation research.

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


D. Stewart

D. Perumal

N. Abdulrazzaq


While a plethora of studies report antimicrobial stewardship programme (ASP) implementation, these are limited by a lack of theoretical underpinning. This may lead to missing key factors that are likely to influence the successful or unsuccessful implementation. The aim of this study was to explore key stakeholders' perspectives of ASP implementation in United Arab Emirates (UAE) hospitals, with a focus on facilitators and barriers. The study employed a qualitative approach using semi-structured interviews conducted with ASP stakeholders involved in clinical use of antimicrobials at the individual patient level, and including ASP team members and non-members. An interview schedule based on published literature and grounded in the Consolidated Framework for Implementation Research (CFIR) was developed, reviewed, and piloted. Recruitment was via purposive and snowball sampling. Interviews were recorded, transcribed, and thematically analysed by two independent researchers using CFIR as a coding framework. Data saturation was achieved at thirty-one interviews. Multiple CFIR constructs were identified as implementation facilitators or barriers. Facilitators included external policy requirements (both national and international), leadership support, stakeholders' engagement, collaborative culture, effective communication, and forward planning. Barriers included blame culture, complexity of ASP implementation and a shortage of expert personnel. Numerous facilitators and barriers to ASP implementation from a stakeholders' perspective were identified in this research. The value of early leadership engagement to support provision of required resources, a need for effective planning and establishment of multiple engagement techniques, and valuable communication with healthcare providers are the main recommendations emerging to support improvement in clinical practice.


HASHAD, N., STEWART, D., PERUMAL, D., ABDULRAZZAQ, N. and TONNA, A.P. [2023]. Antimicrobial stewardship programme implementation in the UAE: perspectives of key stakeholders using consolidated framework for implementation research. Journal of hospital infection [online], 137, pages 69-76. Available from:

Journal Article Type Article
Acceptance Date May 9, 2023
Online Publication Date May 19, 2023
Publication Date Jul 31, 2023
Deposit Date May 22, 2023
Publicly Available Date May 22, 2023
Journal Journal of hospital infection
Print ISSN 0195-6701
Electronic ISSN 1532-2939
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 137
Pages 69-76
Keywords Antimicrobial stewardship; Consolidated framework for implementation research; United Arab Emirates; Qualitative; Theory
Public URL
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 the file associated with this output.


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