Assessment of current antimicrobial stewardship policies and resources: a focus group project

IntroductionAntimicrobial stewardship (AS) within acute care facilities is a requirement for Accreditation Canada's Required Organisational Practices. In order to obtain a baseline evaluation of current AS processes, a focus group approach was used to qualitatively assess frontline pharmacy staff and leadership perspectives on AS resources.MethodsA semi-structured interview process was applied to focus groups comprised of Pharmacy Services employees throughout Alberta Health Services in Alberta, Canada. A thematic analysis of transcripts was done independently by two investigators, and consensus was reached on identified themes and topics. Codes were recorded for prevalence and total number of mentions. A combination of conventional and deductive approaches was used to identify themes.ResultsA total of 200 (10%) pharmacy services staff members participated in the focus groups. Eight main themes were identified: antimicrobial resources, influences on antimicrobial utilisation, barriers to antimicrobial stewardship, establishing AS teams, education needs, improving communications, antimicrobial utilisation concerns, and enablers for improvement. Two hundred and six topics were identified to support the themes, with 1924 data points. Prominent topics included ubiquitous awareness of a provincial antimicrobial stewardship reference, prescriber preferences influencing antimicrobial utilisation, and desire to improve interprofessional teamwork, communication and educational opportunities.ConclusionsA broad description of the culture of antimicrobial use showed that the themes are interrelated. To successfully change practice, one must take into account the complexity of the relationship between these perceptions.