Developing an Antimicrobial Stewardship Education Curriculum Framework

Simple item page
dc.contributor.advisorKassam, Aliya
dc.contributor.authorConstantinescu, Cora Mihaela
dc.contributor.committeememberConly, John M.
dc.contributor.committeememberVayalumkal, Joseph Varkey
dc.contributor.committeememberGilfoyle, Elaine
dc.date2021-06
dc.date.accessioned2021-03-05T22:20:50Z
dc.date.available2021-03-05T22:20:50Z
dc.date.issued2021-03-03
dc.description.abstractBackground: Antimicrobial Stewardship (AS) education initiatives often neglect to account for the psychosocial factors driving antimicrobial prescribing (AP). Understanding these key factors is important in the design and implementation of tailored educational initiatives. Methods: This study which applied a mixed-methods embedded design, involved quantitative analysis of AS concerns observed by pharmacists through a clinical team rounds audit, as well as qualitative semi-structured interviews based on the Theoretical Domain Framework (TDF). Interviews (n=23) with staff and resident physicians, nurse practitioners and pharmacists were conducted for the Clinical Teaching Unit (CTU) and Pediatric Intensive Care Unit (PICU). We analyzed the data using deductive and inductive methods by mapping nodes from the TDF to a model for social determinants of antimicrobial prescribing (SDAP) in pediatrics. Facilitators and barriers to AP behaviour were identified and represented with respect to Kern’s Model of curriculum development targeted at future PICU and CTU AS education initiatives. Results: The quantitative phase served as an educational needs assessment, identifying chief AS practice (e.g., de-escalation) and antibiotics concerns. The qualitative phase explored AP behaviours and identified psychosocial facilitators and barriers for AS practice. Some facilitators included: 1. Collaboration and trust, 2. Shared decision-making with pharmacy and the Infectious Disease (ID) service, 3. Local accessible guidelines and 4. Overarching goals such as: doing right by the patient and feeling empowered as a prescriber. Some barriers included: 1. The norm of non-interference, 2. Professional comparisons including issues with hierarchy and egos, 3. Limited resources, 4. Feeling inadequately trained in AS, 5. Emotional prescribing in the face of clinical deterioration and diagnostic uncertainty and 6. Pejorative monitoring system. A conceptual framework was then developed using these facilitators and barriers for future educational initiatives for inpatient teams. Conclusions: This study contributes to the gap of knowledge around how best to optimize AS education for multidisciplinary teams. This is the first study in pediatrics taking into consideration the psychosocial drivers of AP behaviour in the context of team decisions around patient-centred clinical rounds. Mapping these facilitators and barriers to an established educational framework, allows for tailored curriculum development of future AS interventions.en_US
dc.identifier.citationConstantinescu, C. M. (2021). Developing an Antimicrobial Stewardship Education Curriculum Framework (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.en_US
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/38664
dc.identifier.urihttp://hdl.handle.net/1880/113133
dc.language.isoengen_US
dc.publisher.facultyCumming School of Medicineen_US
dc.publisher.institutionUniversity of Calgaryen
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.en_US
dc.subjectantimicrobialen_US
dc.subjectprescribingen_US
dc.subjecteducationen_US
dc.subjectstewardshipen_US
dc.subjectpediatricsen_US
dc.subject.classificationEducation--Adult and Continuingen_US
dc.subject.classificationEducational Psychologyen_US
dc.subject.classificationMedicine and Surgeryen_US
dc.subject.classificationPsychology--Behavioralen_US
dc.titleDeveloping an Antimicrobial Stewardship Education Curriculum Frameworken_US
dc.typemaster thesisen_US
thesis.degree.disciplineMedicine – Community Health Sciencesen_US
thesis.degree.grantorUniversity of Calgaryen_US
thesis.degree.nameMaster of Science (MSc)en_US
ucalgary.item.requestcopytrueen_US
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
ucalgary_2021_constantinescu_cora.pdf
Size:
2.37 MB
Format:
Adobe Portable Document Format
Description:
Master's Thesis PDF Format
Download
License bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
license.txt
Size:
2.62 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Open Theses and Dissertations