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

dc.check.date2021-10-01
dc.check.infoAccess to this article is restricted until 12 months after publication by request of the publisher.en
dc.contributor.authorO'Riordan, Frank
dc.contributor.authorShiely, Frances
dc.contributor.authorByrne, Stephen
dc.contributor.authorFleming, Aoife
dc.date.accessioned2020-10-30T11:45:17Z
dc.date.available2020-10-30T11:45:17Z
dc.date.issued2020-10-01
dc.description.abstractBackground 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.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationO’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/s11096-020-01159-1en
dc.identifier.doi10.1007/s11096-020-01159-1en
dc.identifier.endpage9en
dc.identifier.issn2210-7711
dc.identifier.journaltitleInternational Journal of Clinical Pharmacyen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/10685
dc.language.isoenen
dc.publisherSpringeren
dc.relation.urihttps://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/s11096-020-01159-1en
dc.subjectAntimicrobial stewardshipen
dc.subjectRespiratory tract infectionsen
dc.subjectProcalcitoninen
dc.subjectProcess evaluationen
dc.subjectConsolidated Framework for Implementation Researchen
dc.titleA qualitative process evaluation of the introduction of procalcitonin testing as an antimicrobial stewardship interventionen
dc.typeArticle (peer-reviewed)en
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