A qualitative process evaluation of the introduction of procalcitonin testing as an antimicrobial stewardship intervention

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dc.contributor.author O'Riordan, Frank
dc.contributor.author Shiely, Frances
dc.contributor.author Byrne, Stephen
dc.contributor.author Fleming, Aoife
dc.date.accessioned 2020-10-30T11:45:17Z
dc.date.available 2020-10-30T11:45:17Z
dc.date.issued 2020-10-01
dc.identifier.citation O’Riordan, F., Shiely, F., Byrne, S. and Fleming, A. (2020) 'A qualitative process evaluation of the introduction of procalcitonin testing as an antimicrobial stewardship intervention', International Journal of Clinical Pharmacy, (9 pp). doi: 10.1007/s11096-020-01159-1 en
dc.identifier.startpage 1 en
dc.identifier.endpage 9 en
dc.identifier.issn 2210-7711
dc.identifier.uri http://hdl.handle.net/10468/10685
dc.identifier.doi 10.1007/s11096-020-01159-1 en
dc.description.abstract Background Successful antimicrobial stewardship interventions are imperative in today’s environment of antimicrobial resistance. New antimicrobial stewardship interventions should include qualitative analysis such as a process evaluation to determine which elements within an intervention are effective and provide insight into the context in which the intervention is introduced. Objective To assess the implementation process and explore the contextual factors which influenced implementation. Setting An academic teaching hospital in Cork, Ireland. Methods A process evaluation was conducted on completion of a feasibility study of the introduction of a procalcitonin antimicrobial stewardship intervention. The process evaluation consisted of semi-structured face-to-face interviews of key stakeholders including participating (senior) doctors (5), medical laboratory scientists (3) and a hospital administrator. The Consolidated Framework for Implementation Research was used to guide data collection, analysis, and interpretation. Main outcome measures Qualitative assessment of the intervention implementation process, the contextual factors which influenced implementation and identification of improvements to the intervention and its implementation and determine if proceeding to a randomised controlled trial would be appropriate. Results Analysis of the interviews identified three main themes. (1) The procalcitonin intervention and implementation process was viewed positively to support prescribing decisions. Participants identified modifications to procalcitonin processing and availability to improve implementation and allow procalcitonin to be “more of a clinical influence”. (2) In the antimicrobial stewardship context the concept of fear of missing an infection and risks of potentially serious outcomes for patients emerged. (3) The hospital context consisted of barriers such as available resources and facilitators including the hospital culture of quality improvement. Conclusion This process evaluation provides a detailed analysis of the implementation of procalcitonin testing as an antimicrobial stewardship intervention. The positive findings of this process evaluation and feasibility study should be built upon and a full randomised controlled trial and economic evaluation should be conducted in a variety of hospital settings to confirm the effectiveness of procalcitonin as an antimicrobial stewardship intervention. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Springer en
dc.relation.uri https://link.springer.com/article/10.1007/s11096-020-01159-1
dc.rights © Springer Nature Switzerland AG 2020. This is a post-peer-review, pre-copyedit version of an article published in International Journal of Clinical Pharmacy. The final authenticated version is available online at: http://dx.doi.org/10.1007/s11096-020-01159-1 en
dc.subject Antimicrobial stewardship en
dc.subject Respiratory tract infections en
dc.subject Procalcitonin en
dc.subject Process evaluation en
dc.subject Consolidated Framework for Implementation Research en
dc.title A qualitative process evaluation of the introduction of procalcitonin testing as an antimicrobial stewardship intervention en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Frank O'Riordan, School of Pharmacy, University College Cork, Cork, Ireland University College Cork, Cork, Ireland. +353-21-490-3000 en
dc.internal.availability Full text available en
dc.check.info Access to this article is restricted until 12 months after publication by request of the publisher. en
dc.check.date 2021-10-01
dc.description.version Accepted Version en
dc.description.status Peer reviewed en
dc.identifier.journaltitle International Journal of Clinical Pharmacy en
dc.internal.IRISemailaddress f.shiely@ucc.ie en
dc.internal.IRISemailaddress stephen.byrne@ucc.ie en
dc.internal.IRISemailaddress a.fleming@ucc.ie en


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