Antibiotic prescribing in long-term care facilities: a qualitative, multidisciplinary investigation.
Antibiotic prescribing in long-term care facilities: a qualitative, multidisciplinary investigation.
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DOI：
10.1136/bmjopen-2014-006442
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发表时间：
2014-11-05
期刊：
影响因子：
2.9
通讯作者：
Byrne S
中科院分区：
文献类型：
--
作者：
Fleming A;Bradley C;Cullinan S;Byrne S
探讨医疗保健专业人员对长期护理机构（ltcf）抗生素处方的看法。利用这些发现来推荐ltcf中抗菌素管理的干预策略。进行了定性半结构化访谈。采用主题内容分析法对数据进行分析。访谈结束后，将新发现映射到理论领域框架（TDF）中，并使用行为改变轮和行为改变技术（BCT）分类法来推荐未来的干预策略。在2012年12月至2013年3月期间，对在长期护理中心工作的37名保健专业人员（10名全科医生、4名咨询医生、14名护士、9名药剂师）进行了访谈。采访是在大科克地区进行的。从TDF中出现的主要领域是：“知识”、“环境背景和资源”、“社会影响”、“对结果的信念”、“记忆、注意力和决策”，研究结果确定了对“行为调节”的需求。尽管缺乏监测活动，许多参与者认为抗生素处方在他们的长期cf中是令人满意的。本研究使用TDF和BCT分类法，发现ltcf中的抗生素处方受到许多社会和背景因素的影响。环境和患者群体的挑战，对患者后果的信念，以及缺乏关于抗生素处方模式的指南和知识的实施，都是需要解决的重大挑战。根据研究结果以及TDF和BCT分类的应用，我们提出了ltcf中抗菌药物管理的一些实际干预功能。
To explore healthcare professionals’ views of antibiotic prescribing in long-term care facilities (LTCFs). To use the findings to recommend intervention strategies for antimicrobial stewardship in LTCFs. Qualitative semistructured interviews were conducted. The data were analysed by thematic content analysis. After the interviews, the emerging findings were mapped to the theoretical domains framework (TDF), and the behaviour change wheel and behaviour change technique (BCT) taxonomy were used to recommend future intervention strategies. Interviews were conducted with 37 healthcare professionals who work in LTCFs (10 general practitioners, 4 consultants, 14 nurses, 9 pharmacists) between December 2012 and March 2013. Interviews were conducted in the greater Cork region. The main domains from the TDF which emerged were: ‘Knowledge’, ‘Environmental context and resources’, ‘Social influences’, ‘Beliefs about consequences’, ‘Memory, attention and decision making’, with the findings identifying a need for ‘Behavioural regulation’. Many participants believed that antibiotic prescribing was satisfactory at their LTCF, despite the lack of surveillance activities. This study, using the TDF and BCT taxonomy, has found that antibiotic prescribing in LTCFs is influenced by many social and contextual factors. The challenges of the setting and patient population, the belief about consequences to the patient, and the lack of implementation of guidelines and knowledge regarding antibiotic prescribing patterns are significant challenges to address. On the basis of the study findings and the application of the TDF and BCT taxonomy, we suggest some practical intervention functions for antimicrobial stewardship in LTCFs.
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影响因子：
4.5
作者：
Nicolle, LE;Bentley, DW;Smith, PW
通讯作者：
Smith, PW
DOI：
10.1186/1748-5908-6-42
发表时间：
2011-04-23
期刊：
Implementation science : IS
影响因子：
--
作者：
Michie S;van Stralen MM;West R
通讯作者：
West R
影响因子：
7.2
作者：
Duncan, Eilidh M.;Francis, Jill J.;Bond, Christine
通讯作者：
Bond, Christine
DOI：
10.1093/cid/cit212
发表时间：
2013-07
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Charani E;Castro-Sanchez E;Sevdalis N;Kyratsis Y;Drumright L;Shah N;Holmes A
通讯作者：
Holmes A
DOI：
10.1186/1748-5908-7-37
发表时间：
2012-04-24
期刊：
Implementation science : IS
影响因子：
--
作者：
Cane J;O'Connor D;Michie S
通讯作者：
Michie S