Antimicrobial stewardship programs (ASP) are rapidly expanding in pediatric hospitals. Programs must choose a strategy for educating and communicating with providers. However, preferences relating to ASP at multiple pediatric institutions are not well known.
As part of a quality improvement effort, we distributed online confidential surveys to all prescribers at Boston Children’s Hospital (BCH) and Children’s Hospital Colorado (CHCO). Survey items were similar but not identical at each institution; the CHCO survey was fielded in March 2013 before ASP implementation, and the BCH survey in March 2015 as preparation for ASP expansion. Descriptive results were compiled for each institution.
Surveys were collected from 252 prescribers at BCH and 154 at CHCO. Most respondents were attending physicians (54%) and practiced in the inpatient setting (66%). Over half of surveyed providers were unaware of the existent or planned ASP (BCH 62%, CHCO 57%). While most providers reported seeing antibiotic-resistant infections with at least regular frequency (BCH 77%, CHCO 58%), fewer expressed a high comfort level when prescribing antibiotics (BCH 6.1%, CHCO 18.8%). Most providers felt that antimicrobial stewardship would never or rarely interfere with patient care (BCH 66%, CHCO 81%). Preferred methods of communication for ASP recommendations were email (60%) and electronic documentation (45%) at BCH, and phone call (33%) and email (26%) at CHCO. For prescribing guidance at BCH, providers preferred website (65%) and order-based guidance (65%). For ASP approaches at CHCO, providers preferred prospective audit and feedback at 24 hours (69%) or 72 hours (38%) over antibiotic restriction (19%).
Provider characteristics and perceptions of pediatric ASP were similar at two freestanding children’s hospitals. At both institutions, email was a preferred method of receiving recommendations, and electronic prescribing guidance was viewed positively. Opportunities exist to increase provider awareness of ASP and comfort level in treating antibiotic-resistant organisms. Institutions initiating or expanding a pediatric ASP should elicit preferences from providers to guide strategic planning.
K. B. Flett,
S. Jones, None
S. Parker, None
T. J. Sandora, None