Development of a web-based application to improve data collection for antimicrobial point prevalence surveys in the public health care system in South Africa; findings and implications (Preprint)

Abstract

Determining antimicrobial utilization patterns in hospitals can be a challenge given personnel and resource constraints with paper based systems. A web–based application (APP) was developed in South Africa to address this, building on a recent pilot point prevalence survey (PPS) using a paper-based system.

The study aim was to test and refine the develop app as well as to evaluate its ease of use and potential time saving versus paper based methods.

The developed app was tested in a large academic public hospital in a PPS in South Africa. During data collection phase, the app was evaluated for functionality on all 35 variables and subsequently refined. After the data collection, the app was evaluated in terms of its time saving potential and ease of use.

181 patient’s files were surveyed across 13 wards in the hospital, with the findings similar to the paper-based study. The median age for males was 45.5 years and the median age for females was 42 years. Overall 80 out of 181 (44%) patients received antibiotics. Whilst 38% (12 out of 31) of patients in the adult surgical ward received antimicrobials, the prevalence was the highest (78%) in the paediatric medical wards. All the data collectors were confident in using the app after training and found the tool not complex at all. In addition, the time taken to plan for the study and to collect data was considerably reduced. Reduced time spending is important for instigating quality improvement programmes in resource limited settings.

All data collectors would recommend the app for future PPS surveys. Several concerns with data entry were identified, which have now been addressed in both the refined app as well as in future training. The app development has been successful and is now being deployed across South Africa as part of a national PPS.