Antimicrobial stewardship strategy implementation and impact in acute care spinal cord injury and disorder units

The Journal of Spinal Cord Medicine, 2025 · DOI: 10.1080/10790268.2023.2277963 · Published: November 21, 2023

Simple Explanation

Antimicrobial Stewardship Programs (ASPs) are essential for improving antibiotic use, especially in high-risk populations like those with spinal cord injuries (SCI/D). This study surveyed clinicians and ASP leaders in VA facilities to understand the implementation and impact of various AS strategies. The survey assessed the perceived level of implementation and impact of 33 Antimicrobial Stewardship (AS) strategies. Results showed that implementation varied across VA facilities, and there were differences in perceptions between SCI/D clinicians and ASP leaders. The findings suggest a need for better communication and education to align perceptions and improve the adoption of effective AS strategies in SCI/D units. Future work should implement highly impactful AS strategies according to facility and unit needs.

Study Duration

June 2018 through March 2019

Participants

45 people across 18 sites

Evidence Level

Not specified

Key Findings

1
AS strategy implementation varied across VA facilities, with pre-authorization being perceived as highly impactful (78%) and fully implemented (82%).
2
SCI/D clinicians were less aware of the implementation of AS strategies related to reporting requirements compared to ASP leaders.
3
SCI/D clinicians rated strategies guiding treatment duration and limiting C. difficile antibiotic exposure as more impactful than ASP leaders.

Research Summary

This study assessed the implementation and impact of antimicrobial stewardship (AS) strategies in spinal cord injury and disorder (SCI/D) units across Veterans Affairs (VA) facilities. The results revealed variations in AS strategy implementation across different VA facilities and discrepancies in perceptions between SCI/D clinicians and ASP leaders regarding the impact and implementation of these strategies. The study highlights the need for targeted education and collaborative efforts to improve the adoption of impactful AS strategies, tailored to the specific needs of SCI/D units.

Practical Implications

Enhance Communication

Improve communication between ASP leaders and SCI/D clinicians to align perceptions regarding AS strategy implementation and impact.

Targeted Education

Develop targeted education programs for SCI/D clinicians to increase their awareness of AS strategies, particularly those related to reporting requirements.

Tailored Strategies

Implement AS strategies that are tailored to the specific needs of SCI/D units, considering the perspectives of both clinicians and ASP leaders.

Study Limitations

1
The national sample describes practices within VA, which may not be generalizable to care for patients with SCI/D outside the VA system.
2
The overall sample size was low for making comparisons (n = 45 completed checklists) and participation in the survey varied by site
3
Data collected as part of this study relied on self-reported data regarding individual’s perceptions of implementation and potential impact of a given AS strategy.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury