CURRENT STEWARDSHIP AND EDUCATIONAL ACTIVITY IN RUSSIA FINDINGS FROM A SURVEY

Transcription

1 Second UK-Russia roundtable discussion «Antimicrobial resistance (AMR): actions, plans, implementation» CURRENT STEWARDSHIP AND EDUCATIONAL ACTIVITY IN RUSSIA FINDINGS FROM A SURVEY Ivan Palagin Institute of Antimicrobial Chemotherapy (IAC), Smolensk State Medical University February 2017, Moscow, Russia

2 Purpose of the survey to define and make recommendations for an educational training framework Development and implementation of interventions that will improve effective prescribing Reduce antibiotic resistance rate across Russia

3 Murmansk Yakutsk Krasnodar Ekaterinburg Novokuznetsk Ulan-Ude Krasnodar (n=637) Murmansk (n=191) Yakutsk (n=239) Ulan-Ude (n=160) Novokuznetsk (n=52) Ekaterinburg (n=79) Total number of surveyed

4 Public or governmental hospital 97.7% Primary care center (outpatient department) 1.6% Perinatal / maternity welfare clinic 0.4% Private hospital 0.2% Research organization 0.1%

5 53% Part of your job in relation to antimicrobials: Prescribe 33% 42% Monitor the need and appropriateness of the antimicrobial during therapy 16% Teach about infection diagnosis and treatment 6% Develop antimicrobial prescribing policy and guidelines 2% Purchase 1% None of the above 60% 1% 1% 3% Nurse Doctor Microbiologist Pharmacist Other

6 Therapy 31% Surgery Intensive care medicine 20% 19% Obstetrics/ Gynaecology 11% Microbiology 4% Healthcare admin 2% Clinical pharmacology Pharmacy Epidemiology 1% 1% 0.4% Other 10% No answer 0.2%

7 HAVE YOU RECEIVED UNDERGRADUATE EDUCATION OR TRAINING IN ANTIMICROBIAL STEWARDSHIP? YES 57% NO 34% NOT SURE 5% NOT RELEVANT 2% No answer 2% HAVE YOU RECEIVED POSTGRADUATE EDUCATION OR TRAINING IN ANTIMICROBIAL STEWARDSHIP? YES 39% NO 52% NOT SURE 5% NOT RELEVANT 1% No answer 3% Who was the training provided by? Employing hospital 28% Medical university or college 22% Conference 13% Professional organisation (society) 5% Another hospital 4% National or regional governmental agency 4% Pharmaceutical company 3%

8 ROLE OF MICROBIOLOGISTS IN INSTITUTION / ORGANISATION Do microbiologists have clinical component of work (ward rounds, prescribing etc.)? YES 47% NO 37% NOT SURE 14% NO ANSWER 2% Are the microbiologists based largely in the microbiological laboratory? YES 64% NO 6% NOT SURE 9% NO ANSWER 21%

9 ANTIMICROBIAL STEWARDSHIP IN INSTITUTION / ORGANISATION Is there a committee or group for infection control and/or antimicrobial stewardship? YES 73% NO 11% NOT SURE 14% NO ANSWER 2%

10 ANTIMICROBIAL STEWARDSHIP IN INSTITUTION / ORGANISATION Does it have initiatives or interventions that target antimicrobial prescribing? YES 69% NO 12% NOT SURE 16% NO ANSWER 3%

11 ANTIMICROBIAL STEWARDSHIP IN INSTITUTION / ORGANISATION Role of healthcare professionals in antimicrobial stewardship Doctors 81% Microbiologists 63% Pharmacists 62% Epidemiologists 58% Clinical pharmacologists 7% Nurses 7%

12 EDUCATION IN ANTIMICROBIAL STEWARDSHIP IN INSTITUTION / ORGANISATION Is there a formal strategy or framework for developing and delivering education and training in antimicrobial stewardship? YES 63% NO 14% NOT SURE 20% NO ANSWER 3%

13 DO HEALTHCARE WORKERS RECEIVE EDUCATION OR TRAINING IN ANTIMICROBIAL STEWARDSHIP? At induction During employment YES NO NOT SURE 24% 55% 17% 57% 25% 15% NO ANSWER 4% 3%

14 IS EDUCATION OR TRAINING IN ANTIMICROBIAL STEWARDSHIP MANDATORY? At induction During employment YES NO NOT SURE NOT RELEVANT 16% 32% 14% 1% 50% 4% 8% 1% NO ANSWER 37% 37%

15 Covered topics At induction During employment Minimize unnecessary prescribing of antimicrobials 18% 34% Ensure adequate and prompt timing of antimicrobial administration 23% 38% Ensure appropriate duration of antibiotic treatment and duration as a driver for resistance 19% 34% Adopt necessary infection prevention and control measures 22% 49% Intravenous administration only in severely ill and/or unable to tolerate oral treatment 13% 33% Obtain biological samples for microscopy, culture and sensitivity testing 14% 38% Review micro results daily, deescalate to narrow-spectrum treatment promptly 8% 16% Review intravenous treatment daily, switch to oral route promptly 8% 16% Therapeutic drug monitoring, following adequate and/or adjusted dosing 12% 20% Require single dose surgical prophylaxis regimens as appropriate 9% 18% The role of pharmacokinetics and/or pharmacodynamics in optimising prescribing The role of behaviour change and improvement science in supporting better prescribing 9% 14% 5% 10%

16 At induction During employment Face-to-face lectures and presentations 17% 55% Face-to-face workshops and seminars 9% 29% Providing with clinical guidelines, recommendations and printed materials 17% 41% On the job learning or learning from practice 17% 4% Web-based or e-learning 4% 8% Mixed methods 5% 9%

17 How often is it provided? ANNUALLY OR MORE FREQUENTLY 30% ONCE IN 1-2 YEARS 20% ONCE IN 2-5 YEARS 2% AD HOC 10% No answer 38% Is attendance at this education formally recorded? YES 45% NO 5% NOT SURE 13% No answer 37%

18 Isolation as a single topic As a part of infection prevention/control education or training As a part of public health education or training As a part of patient safety/quality improvement education or training

19 Scale from 1 to 5 with 5 having the greatest importance, % Minimize unnecessary prescribing of antimicrobials, Range (9% - 46%) Administration routes (e.g. intravenous only in severely ill and/or unable to tolerate oral treatment), Range (11% - 33%) Ensure adequate and prompt timing of antimicrobial administration Range (6% - 56%) Ensure appropriate duration of AB treatment and duration as a driver for resistance, Range (8% - 46%) Adopt necessary infection prevention and control measures, Range (5% - 48%) Obtaining of biological samples for microscopy, culture and sensitivity testing, Range (9% - 42%) Therapeutic drug monitoring, adequate and/ or adjusted dosing control, Range (15% - 32%)

20 Scale from 1 to 5 with 5 having the greatest importance, % Review micro results daily, de-escalate to narrowspectrum antibiotic promptly Range (13% - 21%) Role of pharmacokinetics and/or pharmacodynamics in optimising prescribing Range (29% - 17%) Review intravenous treatment daily, switch to oral route promptly Range (15% - 25%) Require single dose prophylaxis regimens as appropriate, Range (22% - 20%) Role of behaviour change and improvement science in supporting better prescribing, Range (30% - 13%)

21 Face-to-face lectures, Range (15% - 54%) Web-based or e-learning, Range (29% - 13%) Face-to-face workshops and seminars, Range (15% - 37%) Articles and books, Range (20% - 22%) Provide clinical guidelines, recommendations and printed materials, Range (11% - 30%) Mixed methods, Range (23% - 20%) On the job learning or learning from practice, Range (10% - 40%)

22 Scale from 1 to 5 with 5 having the greatest responsibility, % Employing hospital, Range (4% - 71%) Professional organisation (society), Range (22% - 13%) Employees own responsibility/commitment, Range (28% - 25%) Private healthcare company, Range (45% - 3%) Another hospital, Range (43% - 13%) Pharmaceutical company, Range (40% - 6%) Medical university or college, Range (13% - 23%) National or regional governmental agency, Range (10% - 43%)

23 Do you think measuring staff participation in education activity should be a metric/indicator for antimicrobial stewardship? YES 78% NO 7% NOT SURE 14% No answer 1%

24 Are you aware of the global free open online course on antimicrobial stewardship YES 14% NO 82% NOT SURE 3% Have you participated in that BSAC online course? YES 3% NO 93% NOT SURE 2% Would translation of this course into Russian increase participation in the course? YES 80% NO 9% NOT SURE 9% No answer 1% No answer 2% No answer 2%

25 ACKNOWLEDGEMENTS COORDINATORS IN THE CENTERS: Nizhegorodtseva Irina (Krasnodar) Gordeeva Svetlana (Murmansk) Portnyagina Ulyana (Yakutsk) Burasova Elena (Ulan-Ude) Domanskaya Olga (Novokuznetsk) Bagin Vladimir (Ekaterinburg)