What factors in the workplace enable success in antimicrobial stewardship in paediatric intensive care? An exploration of antimicrobial stewardship excellence through thematic analysis of appreciative inquiry interviews with healthcare staff

Author:

Roche Emma,Jones Alison,Plunkett AdrianORCID

Abstract

ObjectivesAntimicrobial resistance (AMR) is a major global health problem. Efforts to mitigate AMR prioritise antimicrobial stewardship (AMS) interventions. These interventions typically focus on deficiencies in practice and providing negative or normative feedback. This approach may miss opportunities to learn from success. We aimed to identify factors that enable success in AMS practices in the paediatric intensive care unit (PICU) by analysing the data obtained from interviews with staff members who had achieved success in AMS.DesignQualitative study design using thematic analysis of appreciative inquiry interviews with healthcare staff.Setting31-bedded PICU in the UK between January 2017 and January 2018.Participants71 staff who had achieved success in AMS in the PICU.ResultsSix themes were identified: (1) cultural factors including psychological safety, leadership and positive attitude are important enablers for delivering good clinical care; (2) ergonomic design of the physical environment and ready availability of tools and resources are key elements to support good practice and decision-making; (3) expertise and support from members of the multidisciplinary team contribute to good care delivery; (4) clarity of verbal and written communication is important for sharing mental models and aims of care within the clinical team; (5) a range of intrinsic factors influences the performance of individual HCPs, including organisation skill, fear of failure, response to positive reinforcement and empathetic considerations towards peers; (6) good clinical care is underpinned by a sound domain knowledge, which can be acquired through training, mentorship and experience.ConclusionThe insights gained in this study originate from frontline staff who were interviewed about successful work-as-done. This strengths-based approach is an understudied area of healthcare, and therefore offers authentic intelligence which may be leveraged to effect tangible improvement changes. The methodology is not limited to AMS and could be applied to a wide range of healthcare settings.

Publisher

BMJ

Reference35 articles.

1. HM Government . Tackling antimicrobial resistance 2019-2024: global and public health group emergency preparedness and health protection policy directorate. GovUk January 1, 2019.

2. Davey P , Marwick CA , Scott CL , et al . Interventions to improve antibiotic prescribing practices for hospital Inpatients (updated protocol). Cochrane Database Syst Rev 2017;2. doi:10.1002/14651858.CD003543.pub4

3. NICE guidance: antimicrobial stewardship: systems and processes for effective antimicrobial medicine use. JAC-Antimicrobial Resistance 2019;1. doi:10.1093/jacamr/dlz025

4. Failure modes and effects analysis;Passarella;Control,2018

5. Hollnagel E , Wears RL , Braithwaite J . From safety-I to safety-II: a white paper. 2013.

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3