Monitoring, documenting and reporting the quality of antibiotic use in the Netherlands: a pilot study to establish a national antimicrobial stewardship registry

BMC Infectious Diseases

Research Article

Inger van Heijl¹  Reinier M van Hest²  Tom Sprong³  Jaap ten Oever⁴  Marvin AH Berrevoets⁴  Bart-Jan Kullberg⁴  Ingeborg Groothuis⁵  Jeroen A Schouten⁶  Marlies E Hulscher⁷ 

[1] Department of Clinical Pharmacy, Tergooi Hospital, Hilversum, The Netherlands;Department of Hospital Pharmacy & Clinical Pharmacology, Academic Medical Center, Amsterdam, The Netherlands;Department of Internal Medicine, Division of Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands;Department of Internal Medicine, Division of Infectious Diseases, Radboud university medical center, Nijmegen, The Netherlands;Radboud Center for Infectious Diseases, Radboud university medical center, Nijmegen, The Netherlands;Department of Internal Medicine, Zuiderzee Medical Center, Lelystad, The Netherlands;Scientific Institute for Quality of Healthcare, Radboud university medical center, Nijmegen, The Netherlands;Scientific Institute for Quality of Healthcare, Radboud university medical center, Nijmegen, The Netherlands;Radboud Center for Infectious Diseases, Radboud university medical center, Nijmegen, The Netherlands;

关键词: Antibiotic stewardship;    Quality indicator;    Benchmarking;    Antimicrobial stewardship team;    Antimicrobial stewardship program;    Quality of care;   

DOI  :  10.1186/s12879-017-2673-5

 received in 2017-05-19, accepted in 2017-08-08,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe Dutch Working Party on Antibiotic Policy is developing a national antimicrobial stewardship registry. This registry will report both the quality of antibiotic use in hospitals in the Netherlands and the stewardship activities employed. It is currently unclear which aspects of the quality of antibiotic use are monitored by antimicrobial stewardship teams (A-teams) and can be used as indicators for the stewardship registry. In this pilot study we aimed to determine which stewardship objectives are eligible for the envisioned registry.MethodsWe performed an observational pilot study among five Dutch hospitals. We assessed which of the 14 validated stewardship objectives (11 process of care recommendations and 3 structure of care recommendations) the A-teams monitored and documented in individual patients. They provided, where possible, data to compute quality indicator (QI) performance scores in line with recently developed QIs to measure appropriate antibiotic use in hospitalized adults for the period of January 2015 through December 2015ResultsAll hospitals had a local antibiotic guideline describing recommended antimicrobial use. All A-teams monitored the performance of bedside consultations in Staphylococcus aureus bacteremia and the prescription of restricted antimicrobials. Documentation and reporting were the best for the use of restricted antimicrobials: 80% of the A-teams could report data. Lack of time and the absence of an electronic medical record system enabling documentation during the daily work flow were the main barriers hindering documentation and reporting.ConclusionsFive out of 11 stewardship objectives were actively monitored by A-teams. Without extra effort, 4 A-teams could report on the quality of use of restricted antibiotics. Therefore, this aspect of antibiotic use should be the starting point of the national antimicrobial stewardship registry. Our registry is expected to become a powerful tool to evaluate progress and impact of antimicrobial stewardship programs in hospitals.

【 授权许可】

CC BY   
© The Author(s). 2017