Abstract: Background Many regional and remote (‘regional’) hospitals are without the specialist services that support Antimicrobial Stewardship (AMS) programs in major-city hospitals. This can impact their ability to implement AMS activities. Aim To identify factors which impact on the delivery of AMS programs in regional hospitals. Methods Healthcare clinicians who have primary AMS responsibilities or provide AMS support to a health service or across health services with an Australian Statistical Geography Standard Remoteness classification of inner regional, outer regional, remote or very remote were recruited (purposively and via snowballing). A series of focus groups and interviews were held, and the discussions audiotaped and transcribed verbatim. The transcripts were coded by two researchers and thematic analysis undertaken using a framework method. Findings Four focus groups and one interview were conducted (22 participants). Six main themes that impacted on AMS program delivery were identified; culture of independence and self-reliance by local clinicians, personal relationships, the geographical location of the hospital influencing antimicrobial choice, the local context, inability to meaningfully benchmark performance and lack of resources. Possible strategies to support the delivery of AMS programs in regional hospitals proposed by participants were categorised into two main themes; those that may be best developed or managed centrally and those that should be a local responsibility. Conclusion AMS program delivery in regional hospitals is influenced by factors that are not present in major-city hospitals. These findings provide a strong basis for the development of specific strategies to support regional hospitals to implement sustainable AMS programs.
Bishop, Jaclyn L., Schulz, Thomas R., Kong, David C. M., Buising, Kirsty L., 2018, A qualitative study of the factors impacting Antimicrobial Stewardship program delivery in regional and remote hospitals, Edition:27 September 2018, Journal Article, viewed 16 August 2022, https://www.nintione.com.au/?p=13935.