Background
Methods
Results
Baseline data: coverage, response rate, working setting, and professional profile
Characteristics | African region
n = 8 | Eastern- Mediterranean region n = 13 | European region
n = 67 | Region of Americas
n = 47 | South-East Asia region
n = 8 | Western Pacific region n = 15 | Total
n = 158 |
---|---|---|---|---|---|---|---|
Type of hospital, n (%) | |||||||
- University hospital | 5 (62.5) | 6 (46.1) | 50 (74.6) | 35 (74.5) | 6 (75.0) | 12 (80.0) | 114 (72.1) |
- Community teaching hospital | 2 (25.0) | 3 (23.1) | 14 (20.9) | 9 (19.1) | 1 (12.5) | 1 (6.7) | 30 (19.0) |
- Community hospital | 0 | 2 (15.4) | 3 (4.5) | 1 (2.1) | 1 (12.5) | 2 (13.3) | 9 (5.7) |
- Other | 1 (12.5) | 2 (15.4) | 0 | 2 (4.3) | 0 | 0 | 5 (3.2) |
Hospital setting, n (%) | |||||||
- Urban | 5 (62.5) | 10 (76.9) | 65 (97.0) | 44 (93.6) | 6 (75.0) | 14 (93.3) | 144 (91.1) |
- Suburban | 3 (37.5) | 3 (23.1) | 2 (3.0) | 1 (2.1) | 2 (25.0) | 0 | 11 (7.0) |
- Rural | 0 | 0 | 0 | 2 (4.3) | 0 | 1 (6.7) | 3 (1.9) |
Hospital inpatient beds, n (%) | |||||||
- ≤100 | 0 | 2 (15.4) | 3 (4.5) | 1 (2.1) | 0 | 0 | 6 (3.8) |
- 101–500 | 3 (37.5) | 5 (38.5) | 15 (22.4) | 10 (21.3) | 2 (25.0) | 3 (20.0) | 38 (24.1) |
- 501–1000 | 3 (37.5) | 5 (38.5) | 27 (40.3) | 28 (59.6) | 3 (37.5) | 1 (6.7) | 67 (42.4) |
- ≥ 1000 | 2 (25.0) | 1 (7.7) | 22 (32.8) | 8 (17.0) | 3 (37.5) | 11 (73.3) | 47 (29.7) |
Profession, n (%) | |||||||
Epidemiologist | 1 (12.5) | 0 | 2 (3.0) | 1 (2.1) | 0 | 0 | 4 (2.5) |
Hospital administrator | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Clinical pharmacologist | 0 | 1 (7.7) | 0 | 4 (8.5) | 1(12.5) | 1 (6.7) | 7 (4.4) |
Hospital pharmacist | 0 | 0 | 1 (1.5) | 1 (2.1) | 1 (12.5) | 1 (6.7) | 4 (2.5) |
Infection control specialist | 0 | 0 | 1 (1.5) | 1 (2.1) | 0 | 0 | 2 (1.3) |
Infectious diseases specialist | 0 | 4 (30.8) | 10 (14.9) | 10 (21.3) | 0 | 5 (33.3) | 29 (18.4) |
Intensivist | 1 (12.5) | 0 | 5 (7.5) | 2 (4.3) | 0 | 1 (6.7) | 9 (5.7) |
Microbiologist | 3 (37.5) | 3 (23.1) | 1 (1.5) | 1 (2.1) | 3 (37.5) | 0 | 11 (7.0) |
Surgeon | 3 (37.5) | 5 (38.5) | 44 (65.7) | 24 (51.1) | 3 (37.5) | 6 (40.0) | 85 (53.8) |
Other | 0 | 0 | 3 (4.5) | 3 (6.4) | 0 | 1 (6.7) | 7 (4.4) |
Characteristics of the team
Characteristics |
n (%) |
---|---|
Components | |
- Epidemiologist | 64 (41.0) |
- Hospital administrator | 73 (46.8) |
- Clinical pharmacologist | 8 (5.1) |
- Hospital pharmacist | 95 (60.9) |
- Infection control specialist | 106 (67.9) |
- Infectious disease specialist | 125 (80.1) |
- Intensivist | 76 (48.7) |
- Microbiologist | 119 (76.3) |
- Surgeon | 92 (59.0) |
- Other | 11 (7.1) |
- Infectious disease specialist AND hospital pharmacologist/pharmacist | 87 (55.8) |
Frequency of meetings | |
- More than once a week | 15 (9.6) |
- Once a week | 26 (16.7) |
- Twice a month | 13 (8.3) |
- Once a month | 58 (37.2) |
- Less than once a month | 27 (17.3) |
- Only as necessary | 17 (10.9) |
Implementation of protocols and monitoring systems
Implementation of protocols and monitoring systems | All hospital wards
n (%) | Some hospital wards, including surgical wards
n (%) | Some hospital wards, not including surgical wards
n (%) | No hospital wards
n (%) | |
---|---|---|---|---|---|
Every surgical wards | Some surgical wards | ||||
- SAP protocol | NA | 124 (78.5) | 28 (17.7) | NA | 6 (3.8) |
- TIS protocol | NA | 70 (44.3) | 60 (38.0) | NA | 28 (17.7) |
- UAMS | 84 (53.2) | 45 (28.5) | 9 (5.7) | 20 (12.7) | |
- RDSR | 104 (65.8) | 26 (16.5) | 7 (4.4) | 21 (13.3) |
Implementations of ASPs and related interventions
Characteristics | Surgical departments, n = 136
n (%) | Other departments, n = 19
n (%) |
P value | Total, n = 155
n (%) |
---|---|---|---|---|
Type of ASPs | ||||
- Persuasive interventions | 23 (16.9) | 7 (36.8) | 0.06a
| 30 (19.4) |
- Restrictive interventions | 14 (10.3) | 3 (15.8) | 0.44a
| 17 (11.0) |
- Both | 99 (72.8) | 9 (47.4) | <0.05 | 108 (69.7) |
Type of interventions | ||||
- Dissemination of educational materials | 85 (62.5) | 8 (42.1) | 0.15 | 93 (60.0) |
- Reminders | 56 (41.2) | 8 (42.1) | 1.00 | 64 (41.3) |
- Audit and feedback | 75 (55.1) | 4 (21.1) | <0.05 | 79 (51.0) |
- Educational outreach | 73 (53.7) | 10 (52.6) | 1.00 | 83 (53.6) |
- Other persuasive interventions | 23 (16.9) | 3 (15.8) | 1.00a
| 26 (16.8) |
- Compulsory order form | 70 (51.5) | 7 (36.8) | 0.34 | 77 (49.7) |
- Expert approval | 83 (61.0) | 5 (26.3) | <0.05 | 88 (56.8) |
- Restriction by removal | 41 (30.1) | 2 (10.5) | 0.13 | 43 (27.7) |
- Review and make changes | 36 (26.5) | 1 (5.3) | <0.05a
| 37 (23.9) |
- Other restrictive interventions | 10 (7.4) | 3 (15.8) | 0.20a
| 13 (8.4) |
Variables | PAP protocol implemented n. (%), p | TIS protocol implemented n. (%), p
| Monitoring system of used antimicrobials n. (%), p | Resistance data systematic reports n. (%), p
| ASP implemented
n. (%), p
| Structural intervention n. (%), p
|
---|---|---|---|---|---|---|
Number of bed | ||||||
Less than 100, n = 6 | 5 (83.3) 1.00a
| 4 (66.7) 0.29a
| 4 (66.7) 0.30a
| 4 (66.7) 0.29a
| 3 (50.0) 0.58a
| 3 (50.0) 0.10a
|
101–500, n = 38 | 37 (97.4) 1.00a
| 32 (84.2) 0.57 | 29 (76.3) 0.80 | 30 (78.9) 1.00 | 32 (84.2) 0.75 | 22 (57.9) <0.05a
|
501–1000, n = 67 | 62 (92.5) 0.08a
| 53 (79.1) 0.49 | 53 (79.1) 0.62 | 56 (83.6) 0.87 | 56 (83.6) 0.75 | 58 (86.6) <0.05a
|
More than 1000, n = 47 | 47 (100.0) 0.18a
| 40 (85.1) 0.71 | 42 (89.4) 0.16 | 39 (83.0) 1.00 | 39 (83.0) 1.00 | 41 (87.2) 0.16 |
Hospital setting | ||||||
Urban, n = 144 | 140 (97.2) 0.09 | 118 (81.9) 1.00a
| 119 (82.6) 0.29a
| 122 (84.7) <0.05a
| 120 (83.3) 0.40a
| 97 (67.4) 0.17a
|
Suburban and rural, n = 14 | 12 (85.7) 0.09 | 12 (85.7) 1.00a
| 11 (78.6) 0.29a
| 9 (64.3) <0.05a
| 10 (71.4) 0.40a
| 9 (64.3) 0.17a
|
Type of hospital | ||||||
University hospital, n = 114 | 110 (96.5) 0.67a
| 92 (80.7) 0.55 | 94 (82.5) 0.84 | 98 (86.0) 0.08 | 92 (80.7) 0.84 | 95 (83.3) <0.05 |
Community teaching hospital, n = 30 | 29 (96.7) 1.00a
| 27 (90.0) 0.33 | 27 (90.0) 0.60 | 24 (80.0) 0.92 | 26 (86.7) 0.77a
| 22 (73.3) 0.54 |
Community hospital, n = 9 | 8 (88.9) 0.30a
| 8 (88.9) 1.00a
| 7 (77.8) 0.67a
| 5 (55.6) 0.05a
| 9 (100.0) 1.00a
| 3 (33.3) <0.05a
|
Other, n = 5 | 5 (100.0) 1.00a
| 3 (60.0) 0.21a
| 3 (60.0) <0.05a
| 4 (80.0) 0.21a
| 4 (80.0) 0.52a
| 4 (80.0) 1.00a
|
Components of the team | ||||||
Epidemiologist, n = 64 | 62 (96.9) 1.00a
| 53 (82.8) 1.00 | 52 (81.3) 1.00 | 59 (92.2) <0.05 | 52 (81.3) 1.00 | 53 (82.8) 0.46 |
Infection control specialist, n = 106 | 103 (97.2) 0.40a
| 90 (84.9) 0.31 | 91 (85.8) 0.08 | 89 (84.0) 0.57 | 89 (84.0) 1.00 | 82 (77.4) 0.79 |
Hospital administrator, n = 73 | 71 (97.3) 0.69a
| 65 (89.0) 0.06 | 61 (83.6) 0.71 | 61 (83.6) 0.86 | 63 (86.3) 0.29 | 59 (80.8) 0.49 |
Hospital pharmacologist, n = 95 | 94 (98.9) <0.05a
| 80 (84.2) 0.57 | 80 (84.2) 0.42 | 82 (86.3) 0.16 | 83 (87.4) 0.29 | 79 (83.2) 0.08 |
Hospital pharmacist, n = 8 | 7 (87.5) 0.27a
| 6 (75.0) 0.43a
| 7 (87.5) 0.55a
| 5 (62.5) 0.15a
| 7 (87.5) 0.36a
| 3 (37.5) <0.05a
|
Infectious diseases specialist, n = 125 | 120 (96.0) 1.00a
| 100 (80.0) v0.23 | 104 (83.2) 0.47 | 103 (82.4) 1.00 | 107 (85.6) 0.15a
| 95 (76.0) 0.50 |
Intensivist, n = 76 | 74 (97.4) 0.68a
| 65 (85.5) 0.41 | 66 (86.8) 0.16 | 63 (82.9) 1.00 | 66 (86.8) 0.80 | 60 (78.9) 1.00 |
Microbiologist, n = 119 | 119 (100.0) 0.64a
| 98 (82.4) 1.00 | 96 (80.7) 0.75 | 100 (84.0) 0.44 | 98 (82.4) 0.82 | 91 (76.5) 0.46 |
Surgeon, n = 92 | 88 (95.7) 1.00a
| 80 (87.0) 0.11 | 77 (83.7) 0.56 | 77 (83.7) 0.73 | 76 (82.6) 0.70 | 70 (76.1) 0.61 |
Other, n = 11 | 11 (100.0) 1.00a
| 9 (81.8) 1.00a
| 11 (100.0) 0.22a
| 10 (90.9) 0.69a
| 10 (90.9) 1.00a
| 8 (72.7) 0.70a
|