Abstract
BackgroundAntimicrobial stewardship programs (ASPs) have been shown to reduce inappropriate antimicrobial use and its consequences. However, these programs lack legislative requirements in many places and it can be difficult to determine what human resources are required for these programs and how to create a business case to present to hospital administrators for program funding. The objectives of the current paper were to review legislative requirements and outline human resource requirements for ASPs, and to create a base business case for ASPs.MethodsA working group of antimicrobial stewardship experts from across Canada met to discuss the necessary components for creation of a business case for antimicrobial stewardship. A narrative review of the literature of the regulatory requirements and human resource recommendations for ASPs was conducted. Informed by the review and using a consensus decision-making process, the expert working group developed human resource recommendations based on a 1000 bed acute care health care facility in Canada. A spreadsheet based business case model for ASPs was also created.ResultsLegislative and /or regulatory requirements for ASPs were found in 2 countries and one state jurisdiction. The literature review and consensus development process recommended the following minimum human resources complement: 1 physician, 3 pharmacists, 0.5 program administrative and coordination support, and 0.4 data analyst support as full time equivalents (FTEs) per 1000 acute care beds. Necessary components for the business case model, including the human resource requirements, were determined to create a spreadsheet based model.ConclusionsThere is evidence to support the negative outcomes of inappropriate antimicrobial use as well as the benefits of ASPs. Legislative and /or regulatory requirements for ASPs are not common. The available evidence for human resource recommendations for ASPs using a narrative review process was examined and a base business case modelling scenario was created. As regulatory requirements for ASPs increase, it will be necessary to create accurate business cases for ASPs in order to obtain the necessary funding to render these programs successful.
Highlights
Antimicrobial stewardship programs (ASPs) have been shown to reduce inappropriate antimicrobial use and its consequences
ASPs were incorporated as a Required Organization Practice by Accreditation Canada and are a required component in acute care hospitals since January 2013 [14]
Antimicrobial stewardship was included in the National Safety and Quality Health Service Standards required for hospital accreditation in Australia in 2012 [15]
Summary
Antimicrobial stewardship programs (ASPs) have been shown to reduce inappropriate antimicrobial use and its consequences. These programs lack legislative requirements in many places and it can be difficult to determine what human resources are required for these programs and how to create a business case to present to hospital administrators for program funding. The objectives of the current paper were to review legislative requirements and outline human resource requirements for ASPs, and to create a base business case for ASPs. Antimicrobials are medications used for the treatment of infectious diseases and their development and use in the twentieth century has contributed substantially to a decline in infectious disease-related mortality [1]. Antimicrobial overuse is considered the principal driver in selecting for antimicrobial-resistant organisms with a strong association between rising rates of use and increasing rates of antimicrobial resistant organisms in both inpatient and ambulatory settings [5–9]
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