TY - JOUR
T1 - Organizational readiness assessment in acute and long-term care has important implications for antibiotic stewardship for asymptomatic bacteriuria
AU - Goebel, Melanie C.
AU - Trautner, Barbara W.
AU - Wang, Yiqun
AU - Van, John N.
AU - Dillon, Laura M.
AU - Patel, Payal K.
AU - Drekonja, Dimitri M.
AU - Graber, Christopher J.
AU - Shukla, Bhavarth S.
AU - Lichtenberger, Paola
AU - Helfrich, Christian D.
AU - Sales, Anne
AU - Grigoryan, Larissa
N1 - Funding Information:
Conflicts of interest: Dr. Trautner reports grants from VA HSR&D, during the conduct of the study; grants from NIH, AHRQ, CDC, grants and personal fees from Zambon pharamceuticals, personal fees from Paratek pharmaceuticals, outside the submitted work. Dr. Grigoryan reports grants from NIH, AHRQ, VA HSR& D, grants from Zambon Pharmaceuticals, grants from Rebiotix, outside the submitted work.
Funding Information:
Potential conflicts of interest: Two authors received funding support from Zambon Pharmaceuticals for investigator-initiated research.
Funding Information:
Financial support: This work was supported by the Veterans’ Affairs Health Services Research and Development Service (grant no. IIR 16-025) and by the Center for Innovations in Quality, Effectiveness and Safety (grant no. CIN 13-413) at the Michael E. DeBakey VA Medical Center, Houston, Texas.
Funding Information:
Financial support: This work was supported by the Veterans? Affairs Health Services Research and Development Service (grant no. IIR 16-025) and by the Center for Innovations in Quality, Effectiveness and Safety (grant no. CIN 13-413) at the Michael E. DeBakey VA Medical Center, Houston, Texas. Potential conflicts of interest: Two authors received funding support from Zambon Pharmaceuticals for investigator-initiated research. Conflicts of interest: Dr. Trautner reports grants from VA HSR&D, during the conduct of the study; grants from NIH, AHRQ, CDC, grants and personal fees from Zambon pharamceuticals, personal fees from Paratek pharmaceuticals, outside the submitted work. Dr. Grigoryan reports grants from NIH, AHRQ, VA HSR& D, grants from Zambon Pharmaceuticals, grants from Rebiotix, outside the submitted work.
Publisher Copyright:
© 2020 Association for Professionals in Infection Control and Epidemiology, Inc.
PY - 2020/11
Y1 - 2020/11
N2 - Background: Prior to implementing an antibiotic stewardship intervention for asymptomatic bacteriuria (ASB), we assessed institutional barriers to change using the Organizational Readiness to Change Assessment. Methods: Surveys were self-administered on paper in inpatient medicine and long-term care units at 4 Veterans Affairs facilities. Participants included providers, nurses, and pharmacists. The survey included 7 subscales: evidence (perceived strength of evidence) and six context subscales (favorability of organizational context). Responses were scored on a 5-point Likert-type scale. Results: One hundred four surveys were completed (response rate = 69.3%). Overall, the evidence subscale had the highest score; the resources subscale (mean 2.8) was significantly lower than other subscales (P < .001). Scores for budget and staffing resources were lower than scores for training and facility resources (P < .001 for both). Pharmacists had lower scores than providers for the staff culture subscale (P = .04). The site with the lowest scores for resources (mean 2.4) also had lower scores for leadership and lower pharmacist effort devoted to stewardship. Conclusions: Although healthcare professionals endorsed the evidence about nontreatment of ASB, perceived barriers to antibiotic stewardship included inadequate resources and leadership support. These findings provide targets for tailoring the stewardship intervention to maximize success.
AB - Background: Prior to implementing an antibiotic stewardship intervention for asymptomatic bacteriuria (ASB), we assessed institutional barriers to change using the Organizational Readiness to Change Assessment. Methods: Surveys were self-administered on paper in inpatient medicine and long-term care units at 4 Veterans Affairs facilities. Participants included providers, nurses, and pharmacists. The survey included 7 subscales: evidence (perceived strength of evidence) and six context subscales (favorability of organizational context). Responses were scored on a 5-point Likert-type scale. Results: One hundred four surveys were completed (response rate = 69.3%). Overall, the evidence subscale had the highest score; the resources subscale (mean 2.8) was significantly lower than other subscales (P < .001). Scores for budget and staffing resources were lower than scores for training and facility resources (P < .001 for both). Pharmacists had lower scores than providers for the staff culture subscale (P = .04). The site with the lowest scores for resources (mean 2.4) also had lower scores for leadership and lower pharmacist effort devoted to stewardship. Conclusions: Although healthcare professionals endorsed the evidence about nontreatment of ASB, perceived barriers to antibiotic stewardship included inadequate resources and leadership support. These findings provide targets for tailoring the stewardship intervention to maximize success.
KW - Guideline implementation
KW - Health services research
KW - Urinary tract infections
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U2 - 10.1016/j.ajic.2020.04.024
DO - 10.1016/j.ajic.2020.04.024
M3 - Article
C2 - 32437753
AN - SCOPUS:85086149197
VL - 48
SP - 1322
EP - 1328
JO - American Journal of Infection Control
JF - American Journal of Infection Control
SN - 0196-6553
IS - 11
ER -