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Assessing feasibility of establishing antimicrobial stewardship programmes in two provincial-level hospitals in Vietnam: an implementation research study

BMJ open, 2021-10, Vol.11 (10), p.e053343-e053343 [Peer Reviewed Journal]

Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. ;2021 Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. 2021 ;ISSN: 2044-6055 ;EISSN: 2044-6055 ;DOI: 10.1136/bmjopen-2021-053343 ;PMID: 34598989

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  • Title:
    Assessing feasibility of establishing antimicrobial stewardship programmes in two provincial-level hospitals in Vietnam: an implementation research study
  • Author: Huong, Vu Thi Lan ; Ngan, Ta Thi Dieu ; Thao, Huynh Phuong ; Quang, Le Minh ; Hanh, Tran Thi Thu ; Hien, Nguyen Thi ; Duc, Tran ; Vinh, Vu Hai ; Duc, Chau Minh ; Dung Em, Vo Thi Hoang ; Bay, Phan Van Be ; Oanh, Nguyen Thi Thuy ; Hang, Pham Thi Thuy ; Tu, Nguyen Thi Cam ; Quan, Truong Anh ; Kesteman, Thomas ; Dodds Ashley, Elizabeth ; Anderson, Deverick ; van Doorn, H Rogier
  • Subjects: Antibiotics ; Antimicrobial agents ; Antimicrobial Stewardship ; Clinical outcomes ; Drug stores ; Feasibility Studies ; health & safety ; health policy ; health services administration & management ; Hospitals ; Humans ; Infectious Diseases ; Intensive care ; Internal medicine ; Intervention ; Pharmacists ; Planning ; public health ; quality in health care ; Surveillance ; Tropical diseases ; Vietnam
  • Is Part Of: BMJ open, 2021-10, Vol.11 (10), p.e053343-e053343
  • Description: ObjectivesTo investigate the feasibility of establishing hospital-based antimicrobial stewardship (AMS) programmes comprising action-planning, educational interventions and data feedback in two provincial-level hospitals in Viet Nam.Design and settingThis was an implementation research using participatory action process and existing resources from the Duke Antimicrobial Stewardship Outreach Network with local adjustments. A national stakeholder meeting and Strengths-Weaknesses-Opportunities-Threats (SWOT) analysis were conducted to identify gaps and potential interventions.ParticipantsHospital AMS staff implemented activities throughout the study phases. Routinely collected patient data were analysed to support planning, implementation and evaluation.InterventionsHospitals were considered as a complex adaptive system and leveraged their unique characteristics and interconnections to develop 1-year plans containing core interventions (data use, educational training, prospective audit with feedback (PAF) and evaluations).Outcome measuresWe assessed feasibility using outputs from stakeholder meeting, SWOT analysis, baseline data, planning process and implementation.ResultsThe stakeholder meeting identified three gaps for AMS at national level: supportive policies, AMS training and core competencies and collaboration. At the hospitals, AMS programmes took 1 year for planning due to lack of hospital-specific procedures and relevant staff competencies. Baseline data (January–December 2019) showed variations in antibiotic consumption: 951 days of therapy (DOT) per 1000 days present in the control and 496 in the intervention wards in hospital 1, and 737 and 714 in hospital 2, respectively. During 1-year implementation, clinical pharmacists audited 1890 antibiotic prescriptions in hospital 1 (June 2020–May 2021) and 1628 in hospital 2 (July 2020–July 2021), and will continue PAF in their daily work.ConclusionOur data confirmed the need to contextualise AMS programmes in low-income and middle-income countries (LMICs) and demonstrated the usefulness of implementation research design in assessing programme feasibility. Developing staff competencies, using local data to stimulate actions and integrating programme activities in routine hospital work are key to success in LMICs.
  • Publisher: England: British Medical Journal Publishing Group
  • Language: English
  • Identifier: ISSN: 2044-6055
    EISSN: 2044-6055
    DOI: 10.1136/bmjopen-2021-053343
    PMID: 34598989
  • Source: ProQuest One Psychology
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