The impact of COVID-19 on antimicrobial stewardship programme implementation in hospitals: an exploration informed by the consolidated framework for implementation research.

Abstract

The disruption of antimicrobial stewardship programmes (ASP) caused by Coronavirus disease 2019 (COVID-19) has been recognised. This study used a theoretical, qualitative approach to understand the impact of COVID-19 on ASP implementation in hospitals. Semi-structured online interviews, informed by the Consolidated Framework for Implementation Research (CFIR), were conducted with ASP team members and other practitioners involved in antimicrobial prescribing at hospitals in the United Arab Emirates (UAE). Participants were recruited via purposive and snowball sampling, with video-recorded interviews transcribed and independently analysed by two researchers, based on identification of CFIR constructs within emerging themes. Thirty-one interviews were conducted across eleven UAE hospitals. The following themes were identified: (1) increased complexity of ASP implementation and changes in prescribing culture influenced by COVID-19; (2) adaptations, networking and cosmopolitanism to enhance integration of COVID-19 management in ASP services; and (3) adaptations and networking to support continuity of ASP implementation process. A disruption to pre-pandemic ASP activities was reported, with the complexity of COVID-19 overwhelming the healthcare system. ASP team members and services showed an ability to adapt and repurpose roles to respond to the pandemic. Interventions included developing national guidelines for treatment of COVID-19 patients and contributing to guideline management and monitoring. A gradual restoration of ASP activities was perceived. Technological adaptations and enhancements in networking were reported as positive impacts of the pandemic. Despite the initial disruption of ASP implementation due to the pandemic, successful adaptation and evolvement of ASP services reflects the high value and adaptability of ASP implementation in UAE hospitals.

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https://creativecommons.org/licenses/by-nc-nd/4.0/

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Identifiers

DOI

https://doi.org/10.1016/j.jhin.2022.08.005

Repository URI

https://rgu-repository.worktribe.com/output/1635346