Barriers to implementing antimicrobial stewardship programmes in three Saudi hospitals: Evidence from a qualitative study

Alghamdi, Saleh; Atef-Shebl, Nada; Aslanpour, Zoe; Berrou, Ilhem

Abstract

© 2019 International Society for Chemotherapy of Infection and Cancer Objectives: This study explored antimicrobial stewardship programme (ASP) team members’ perspectives regarding factors influencing the adoption and implementation of these programmes in Saudi hospitals. Methods: This was a qualitative study based on face-to-face semistructured interviews with healthcare professionals involved in ASPs and activities across three Ministry of Health (MoH) hospitals in Saudi Arabia (n = 18). Interviews were also conducted with two representatives of a General Directorate of Health Affairs in a Saudi region and two representatives of the Saudi MoH (n = 4) between January–February 2017. Results: Despite the existence of a national strategy to implement ASPs in Saudi MoH hospitals, their adoption and implementation remains low. Hospitals have their own antimicrobial stewardship policies, but adherence to these is poor. ASP team members highlight that lack of enforcement of policies and guidelines from the MoH and hospital administration is a significant barrier to ASP adoption and implementation. Other barriers include disintegration of teams, poor communication, lack of recruitment/shortage of ASP team members, lack of education and training, and lack of health information technology (IT). Physicians’ fears and concerns in relation to liability are also a barrier to their adoption of ASPs. Conclusion: This is the first qualitative study exploring barriers to ASP adoption and implementation in Saudi hospitals from the perspective of ASP team members. Formal endorsement of ASPs from the MoH as well as hospital enforcement of policies and provision of human and health IT resources would improve the adoption and implementation of ASPs in Saudi hospitals.

• Journal Article Type: Article
• Acceptance Date: Jan 28, 2019
• Online Publication Date: Feb 20, 2019
• Publication Date: Sep 1, 2019
• Deposit Date: Mar 6, 2019
• Publicly Available Date: Feb 21, 2020
• Journal: Journal of Global Antimicrobial Resistance
• Print ISSN: 2213-7165
• Peer Reviewed: Peer Reviewed
• Volume: 18
• Pages: 284-290
• DOI: https://doi.org/10.1016/j.jgar.2019.01.031
• Public URL: https://uwe-repository.worktribe.com/output/852047
• Publisher URL: https://doi.org/10.1016/j.jgar.2019.01.031
• Additional Information: Additional Information : This is the author's accepted manuscript. The final published version is available here: https://doi.org/10.1016/j.jgar.2019.01.031
• Contract Date: Mar 6, 2019