Infection Control & Hospital Epidemiology
many of the respondents agreed on many of the perceived barriers and optimal feedback methods, the “one size fits all” approach is limited, and quantitative feedback must incorporate institution- specific awareness and approaches. While the response rate in this study was low, it was similar to
that of a recently published antimicrobial stewardship KAP sur- vey,8 and we primarily surveyed attending level physicians who would likely be affected by provider-specific internal AU reporting as providers of record. The ID and CC groups had the highest completion rates, likely due, in part, to interest in AU issues, which may have created a response bias toward more engaged providers or those who are more responsive to electronic communication given the survey distribution method. Considering these factors, the generalizability of these results may be limited. Antimicrobial stewardship is a shared responsibility across the healthcare con- tinuum through myriad roles including house staff, physician assistants, nurse practitioners, pharmacists, nurses, and many others; future studies looking at all team members are needed. This study provides a framework for other institutions implementing AU feedback; understanding provider opinions can improve acceptance, anticipate operational issues, and inform educational messaging. This study demonstrated general levels of concern with quantitative reporting, lack of consensus of AU attribution, and preference for quarterly e-mails stratified by service compared against similar services with favored metric of average AU. Understanding how feedback of AU rates affects prescribing and appropriateness will be important to optimizing antimicrobial use.
Supplementary material. To view supplementary material for this article, please visit
https://doi.org/10.1017/ice.2018.113
Acknowledgments. The views expressed in this submitted article are not an official position of the institution and only represent the opinions of the authors.
Financial support. This study was supported by a grant from the National Center for Advancing Translational Sciences of the National Institute of Health (grant no. UL1 TR000445).
985
Conflicts of interest. All authors report no conflicts of interest relevant to this article.
References
1. Presidential Advisory Committee on Combating Antibiotic-Resistant Bacteria. National action plan for combating antibiotic-resistant bacteria. Centers for Disease Control and Prevention website.
https://www.cdc.gov/ drugresistance/pdf/national_action_plan_for_combating_antibotic-resistant_ bacteria.pdf. Published March 2015. Accessed July 25, 2017.
2. Antimicrobial use and resistance (AUR) module. Centers for Disease Control and Prevention website.
https://www.cdc.gov/nhsn/PDFs/ pscManual/11pscAURcurrent.pdf. Published 2017. Accessed October 17, 2017.
3. Hafner JM,WilliamsSC, Koss RG,TschurtzBA, Schmaltz SP,Loeb JM. The perceived impact of public reporting hospital performance data: interviews with hospital staff. Int J Qual Health Care 2011; 23:697–704.
4. Lindenauer PK, Lagu T, Ross JS, et al. Attitudes of hospital leaders toward publicly reported measures of health care quality. JAMA Intern Med 2014;174:1904–1911.
5. Hallsworth M, Chadborn T, Sallis A, et al. Provision of social norm feedback to high prescribers of antibiotics in general practice: a pragmatic national randomised controlled trial. Lancet 2016;387(10029):1743–1752.
6. Abbo L, Sinkowitz-Cochran R, Smith L, et al. Faculty and resident physicians’ attitudes, perceptions, and knowledge about antimicrobial use and resistance. Infect Control Hosp Epidemiol 2011;32:714–718.
7. Chaves NJ, Cheng AC, Runnegar N, Kirschner J, Lee T, Buising K. Analysis of knowledge and attitude surveys to identify barriers and enablers of appropriate antimicrobial prescribing in three Australian tertiary hospitals. Intern Med J 2014;44:568–574.
8. Salsgiver E, Bernstein D, Simon MS, et
al.Knowledge,attitudes, and practices regarding antimicrobial use and stewardship among prescribers at acute-care hospitals. Infect Control Hosp Epidemiol 2018;39:316–322.
9. McIntyre MT, Naik L, Bell CM, Morris AM. Development and assessment of a physician-specific antimicrobial usage and spectrum feedback tool. Open Forum Infect Dis 2017;4:ofx124–ofx124.
10. Navathe AS, Emanuel EJ. Physician peer comparisons as a nonfinancial strategy to improve the value of care. JAMA 2016;316:1759–1760.
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100 |
Page 101 |
Page 102 |
Page 103 |
Page 104 |
Page 105 |
Page 106 |
Page 107 |
Page 108 |
Page 109 |
Page 110 |
Page 111 |
Page 112 |
Page 113 |
Page 114 |
Page 115 |
Page 116 |
Page 117 |
Page 118 |
Page 119 |
Page 120 |
Page 121 |
Page 122 |
Page 123 |
Page 124 |
Page 125 |
Page 126 |
Page 127 |
Page 128 |
Page 129 |
Page 130 |
Page 131 |
Page 132 |
Page 133 |
Page 134 |
Page 135 |
Page 136 |
Page 137 |
Page 138 |
Page 139 |
Page 140
