Knowledge, Attitudes, and Perceptions about Antibiotic Stewardship Programs among Neonatology Trainees
Knowledge, Attitudes, and Perceptions about Antibiotic Stewardship Programs among Neonatology Trainees
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DOI：
10.1055/s-0041-1732418
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发表时间：
2021-07-19
影响因子：
2
通讯作者：
Guzman-Cottrill, Judith A.
中科院分区：
文献类型：
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作者：
Kalu, Ibukunoluwa C.;Mukhopadhyay, Sagori;Guzman-Cottrill, Judith A.
目标 抗生素管理应成为新生儿科培训的重要组成部分，因为新生儿重症监护病房 (NICU) 具有独特的管理需求。我们的目的是评估新生儿学奖学金学员对抗生素管理的知识、态度和看法，为可持续课程开发提供信息。研究设计 我们通过研究生医学教育项目主管认证委员会在 4 个月内（2018 年 1 月至 4 月）向美国新生儿学研究员分发了一份电子调查。结果 在美国的 99 个项目中，估计有 700 名研究员，来自 52 个培训项目 (53%) 的 159 名 (23%) 研究员对调查做出了回应，139 名 (87%) 提供了分析答复。大多数受访者在南部（59；42%）和东北（43；31%）地区接受过培训，并且在所有 3 年的培训中分布均匀。一百名 (72%) 受访者报告其机构内有抗生素管理计划 (ASP)。虽然 86% (120/139) 能够识别 ASP 的组成部分，但 59% (82/139) 无法识别或不确定他们是否在研究期间接受过抗生素管理培训。此外，在回答案例研究时，124 名 (89%) 受访者确定了治疗甲氧西林敏感金黄色葡萄球菌 (MSSA) 感染的最佳抗生素，69 名 (50%) 受访者选择了适当的经验性抗生素治疗新生儿脑膜炎。值得注意的是，奖学金培训年份与错误知识反应的比例没有显着相关（p = 0.40）。大多数受访者 (81; 59%) 认为小组会议是最有用的教学形式，而其他人则选择对个人处方行为的审核和反馈 (52; 38%) 和说教讲座 (52; 38%)。最后，95 名 (69%) 受访者更喜欢由学员主导的 ASP 干预措施，针对重点领域，例如抗真菌和手术预防。结论 抗生素管理是新生儿学培训的重要组成部分。新生儿学研究员报告说，他们在培训期间获得 ASP 的情况存在差异。研究员更喜欢在小组环境中教授专门的受训者主导的干预措施和管理课程，以促进有针对性的 NICU ASP。
Objective Antibiotic stewardship should be an essential component of neonatology training as neonatal intensive care units (NICU) have unique stewardship needs. Our aim was to assess neonatology fellowship trainees' knowledge, attitudes, and perceptions about antibiotic stewardship to inform sustainable curriculum development. Study Design We distributed an electronic survey to neonatology fellows in the United States over 4 months (January-April 2018) via Accreditation Council for Graduate Medical Education program directors. Results Of 99 programs in the United States with an estimated 700 fellows, 159 (23%) fellows from 52 training programs (53%) responded to the survey and 139 (87%) provided analyzed responses. Majority of respondents were training in southern (59; 42%) and northeastern (43; 31%) regions and were equally spread across all 3 years of training. One hundred (72%) respondents reported an antibiotic stewardship program (ASP) in their institution. While 86% (120/139) were able to identify the components of an ASP, 59% (82/139) either did not or were unsure if they had received antibiotic stewardship training during fellowship. Furthermore, while answering case studies, 124 (89%) respondents identified the optimal antibiotic for methicillin susceptible Staphylococcus aureus (MSSA) infection and 69 (50%) respondents chose appropriate empiric antibiotics for neonatal meningitis. Notably, fellowship training year was not significantly related to the proportion of incorrect knowledge responses ( p = 0.40). Most survey respondents (81; 59%) identified small group sessions as the most useful teaching format, while others chose audit and feedback of individual prescribing behavior (52; 38%) and didactic lectures (52; 38%). Finally, ninety-five (69%) respondents preferred trainee-led ASP interventions targeting focal areas such as antifungal and surgical prophylaxis. Conclusion Antibiotic stewardship is a critical part of neonatology training. Neonatology fellows report variation in access to ASP during their training. Fellows prefer dedicated trainee-led interventions and stewardship curriculum taught within small group settings to promote targeted NICU ASP.