Antimicrobial Stewardship Program Needs Assessment for Arizona Critical Access Hospitals

Abstract

Specific Aims: This study was undertaken to investigate the specific antimicrobial stewardship (AMS) needs amongst the 15 critical access hospitals (CAHs) and two CAH-status applicants in Arizona and evaluate which factors influenced full versus partial implementation of the 7 CDC Core Elements. Methods: This was an IRB-approved, cross-sectional, qualitative and quantitative study examining data gathered from a questionnaire, which was adapted from a similar survey conducted by Doron et al. The survey was student-administered via telephone to an antimicrobial stewardship program (ASP) member from Arizona’s CAHs and CAH-status applicants. ASP representatives were recruited by contacting each facility’s inpatient pharmacy. The survey included four sections consisting of Likert-scale, multiple choice, and open-response questions that evaluated demographics and ASP practices and protocols if it is present. Results: All representatives surveyed were pharmacists who either led, co-led, or were members of their hospital’s ASP. The majority (70%) were pharmacy directors at their respective facilities. Hospitals that dedicated 20 or more hours per week to antimicrobial stewardship were more likely to report full implementation of the Core Elements (p=0.035). The most frequently reported ASP- related challenge faced by respondents was a lack of ID expertise (31.6%). Conclusions: Due to the budgetary and staffing constraints in rural hospitals, it is often difficult to allocate more hours towards AMS efforts. Increasing dedicated AMS time at Arizona’s CAHs could be an important area to target for additional funding and resources in order to allot more time for stewardship activities and increase Core Elements implementation.