Abstract
ABSTRACT Objective: 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 point prevalence survey (PPS) using a paper-based system. Consequently, there was a need to test and evaluate the ease of use of a newly developed app and potential time saving versus paper-based methods for PPS. The findings can be used to further refine the APP. Methods: The developed app was tested in a large academic public hospital in a PPS in South Africa. During data collection, the app was evaluated for functionality on 35 variables and subsequently refined. After data collection, the app was evaluated in terms of its time-saving potential and ease of use. Results: 181 patient’s files were surveyed across 13 wards in the hospital, with the antimicrobial usage findings similar to the previous paper-based study in the same hospital. The median age for males was 45.5 years and 42 years for females. 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 pediatric medical wards. All the data collectors were confident in using the app after training and found the tool is not complex at all to use. In addition, the time taken to plan for the study and to collect data was considerably reduced. Reduced time spent in data collection and analysis is important for timely instigation of quality improvement programs in resource limited settings. Conclusions: All data collectors would recommend the app for future PPSs. Several concerns with data entry were identified, which have now been addressed. The app development has been successful and is now being deployed across South Africa as part of a national PPS as well as wider.
Highlights
Antimicrobials play a vital role in improving care and redu cing morbidity and mortality in patients with infections [1,2]
Data on antibiotic utilization collected in the Gauteng Province during World Antibiotic Awareness Week in 2015 were not sufficiently robust to make reliable and valid interpretations and recommendations, highlighting the need for valid and reliable surveillance tools to provide a baseline for pertinent quality improvement programs to enhance future antimicrobial use within the public hospitals in South Africa [6,7,21]
As part of the antimicrobial resistance (AMR) National Strategy Framework in South Africa, one of the domains is the strengthening of antimicrobial consumption surveillance, with a situational analysis on AMR performed by the Global Antibiotic Resistance Partnership (GARP) South Africa in 2011
Summary
Antimicrobials play a vital role in improving care and redu cing morbidity and mortality in patients with infections [1,2]. One strategy to improve the use of antimicrobials in hospi tals is the instigation of point prevalence surveys (PPSs) to provide accurate data on current antibiotic utilization and resistance patterns using a standardized methodology to plan future interventions [13,14,15,16,17,18] This is important in South Africa as there are concerns with rationale antibiotic prescribing with high rates of AMR [6,19], and a PPS con ducted in 2015 in a large tertiary hospital in South Africa showed that 31% of patients were receiving antibiotics, with the majority (83%) of antibiotic prescriptions being empirical [20]. As part of the AMR National Strategy Framework in South Africa, one of the domains is the strengthening of antimicrobial consumption surveillance, with a situational analysis on AMR performed by the Global Antibiotic Resistance Partnership (GARP) South Africa in 2011
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