Attitudes towards antimicrobial stewardship: results from a large private hospital in Australia

Introduction

An effective hospital-wide antimicrobial stewardship (AMS) program requires engagement with all healthcare professionals involved in antimicrobial use. It is therefore useful to consider attitudes and perceptions among clinical stakeholders in Australian private hospitals before introducingAMS in these facilities. The aim of this study was to describe perceptions and attitudes towards antimicrobial resistance, antimicrobial use, AMS interventions, and willingness to participate.

Methods

A 26-item attitudinal survey was distributed to visiting specialists, nurses and pharmacists at a large (500 bed) private hospital in Australia. Survey questions utilised ‘Yes/No’ responses and a 7-point Likert scale ranging from ‘strongly agree’ to ‘strongly disagree’. Descriptive analyses were performed and Chi-squared tests conducted.

Results

There were a total of 331 respondents (80 physicians, 58 surgeons, 78 anaesthetists, 105 nurses and 10 pharmacists). The response rate was 42% among clinicians, 100% among pharmacists and 13% among nurses. Only half of the respondents were willing to participate in proposed AMS interventions. A larger proportion of respondents believed that antimicrobial resistance was more of a serious problem in other Australian hospitals compared with the surveyed hospital (62% v. 45%, P < 0.001). Fifty-eight percent agreed that improving prescribing at the hospital would reduce antimicrobial resistance. Twenty-nine percent of respondents had previous exposure to AMS, with pharmacists and physicians more likely to have heard of AMS compared with surgeons, anaesthetists and nurses (P = 0.016 and P < 0.001 respectively).

Conclusions

This study highlights the challenge of making antimicrobial resistance a relevant local issue in private hospitals and engaging key health professionals before implementing change.