A Stewardship-Guided Framework for Improving Antibiotics Use among Children with Acute Respiratory Tract Infections

Egyptian Journal of Health Care Pub Date : 2023-06-01 DOI:10.21608/ejhc.2023.328046

Amal A. Fathalla, Faten M. Nouh, Hanan G. El- Bready, Hanady Sh. Shehata, Azza A. Ghoneim

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Abstract

Background : Most acute respiratory tract infections (ARTIs) in children are due to viral etiology; however, overprescribing of antibiotics for ARTIs is common. Aim: To develop a Stewardship-guided framework for improving antibiotics use among children with ARTIs. Design: A quasi-experimental design (pre-posttest) was utilized for this study. Setting : The Pediatric ward and the pediatric outpatient clinic in Menoufia University Hospital. Sampling: A convenient sample of 43 nurses and a purposive sample of 200 children and their parents were included. Instruments: Five instruments were utilized to get the data. I: Nurses structured interview questionnaire sheet. II: Observational checklist for nurses’ antibiotic Stewardship activities. III: Children structured interview questionnaire sheet (children 9-11 years). IV: Children structured interview questionnaire sheet (children 12-15 years). V: Parents structured interview questionnaire sheet. Results: There was a significant improvement in nurses’ knowledge and antibiotic Stewardship activities. There was a significant improvement in children’ knowledge, beliefs and attitudes regarding antibiotic use. There was a significant decrease in parents’ false knowledge/ information, negative attitude and practices regarding antibiotic use after implementation of the Stewardship-guided framework compared to preintervention. Conclusion : The Stewardship-guided framework was more successful on the posttest than on the pretest in improving nurses’ knowledge and antibiotic stewardship activities as well as children’ knowledge, beliefs and attitudes regarding antibiotic use, and parents’ knowledge, attitudes and practices regarding antibiotic use. Recommendation: Nurses in collaboration with the health care team should integrate the Stewardship-guided framework in all pediatric units and outpatient clinics for improving antibiotic use among pediatric patients.

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改善急性呼吸道感染儿童抗生素使用情况的管理指导框架

背景：大多数儿童急性呼吸道感染（ARTI）都是由病毒引起的，但在治疗 ARTI 时过度使用抗生素的现象却很普遍。目的：制定一个以 "管理 "为指导的框架，以改善急性呼吸道感染患儿的抗生素使用情况。设计：本研究采用准实验设计（前-后测试）。地点：梅努菲亚大学医院儿科病房和儿科门诊。抽样：方便抽样包括 43 名护士，目的抽样包括 200 名儿童及其家长。工具：使用五种工具获取数据。I:护士结构化访谈问卷表。II：护士抗生素管理活动观察核对表。III：儿童结构式访谈问卷表（9-11 岁儿童）。IV：儿童结构式访谈问卷表（12-15 岁儿童）。V：家长结构化访谈问卷表。结果护士的抗生素管理知识和抗生素管理活动均有明显改善。儿童对抗生素使用的知识、信念和态度有了明显改善。与干预前相比，实施抗生素管理指导框架后，家长对抗生素使用的错误知识/信息、消极态度和做法明显减少。结论：在提高护士的抗生素管理知识和抗生素管理活动方面，在提高儿童对抗生素使用的知识、信念和态度方面，在提高家长对抗生素使用的知识、态度和实践方面，"管理指导 "框架的后测效果优于前测效果。建议：护士应与医护团队合作，在所有儿科病房和门诊整合抗生素管理指导框架，以改善儿科患者的抗生素使用情况。

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Egyptian Journal of Health Care

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