Anti-Microbial Resistance in Global Perspective.
- 1st ed.
- 1 online resource (204 pages)
Intro -- Foreword -- Acknowledgments -- Contents -- Contributors -- Acronyms -- List of Figures -- List of Tables -- 1 Introduction to Antimicrobial Resistance and the Maternal Sepsis Intervention -- Antimicrobial Resistance -- A Post-antibiotic Apocalypse? -- Addressing Antimicrobial Resistance on a Global Platform -- The Ugandan Antimicrobial Resistance National Action Plan -- The Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) Project Call -- References -- 2 Autonomy, Evidence and Methods in Global Health -- The Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) Programme -- Fleming Fund Priorities Identified by CwPAMS -- Outcomes Expected from Projects in the CwPAMS Call -- What Outcomes Are Expected from You Through CwPAMS? -- Why Maternal Sepsis? -- Study Context: The Post-natal and Gynaecology Wards at FPRRH -- The Intervention -- Methods Used in the Maternal Sepsis Intervention -- References -- 3 The Impact of the Maternal Sepsis Intervention -- Maternal Deaths from Sepsis at Fort Portal Regional Referral Hospital (FPRRH) -- 'The Road to Death': Understanding the Impact of Geography and Delays -- Impacts on Patients, Their Families, and Livelihoods -- Impact on Patient Stays -- Impacts on Hospital Budgets -- Patient Experiences -- References -- 4 Infection Prevention Control (IPC) and Antimicrobial Resistance (AMR) -- 'Prevention First' -- What Is a Health Care Acquired Infection? -- What Is a Surgical Site Infection? -- Infection Prevention and Control in the Ugandan National Action Plan -- IPC in the Maternal Sepsis Intervention -- Hand Hygiene -- IPC Infrastructure -- Improvements in the Infrastructure Score -- Repair of Sinks -- Infection Prevention and Control and Wound Management -- References -- 5 The Role of Microbiology Testing in Controlling Infection and Promoting Antimicrobial Stewardship. Bacteriology-Based (Individualised) Prescribing -- Facilitating Culture and Sensitivity Testing -- Utilising Laboratory Data and Antibiograms to Improve Empirical Therapy -- Utilising Local Staphylococcus aureus Populations as a Case Study to Investigate Trends in Resistance Patterns -- References -- 6 Task Shifting, Midwifery Empowerment and the Nascence of Clinical Pharmacy -- Procurement and Supply Chain Dynamics in Regional Referral Hospitals -- Antibiotic Distribution at Ward Level in FPRRH -- Discrepancies Between Order and Supply (Order Fill Rates) -- Key Challenges to Sustained Behaviour Change: The Impact of Stock-Outs on AMS -- Interpreting In-Patient Pharmacy Data-A Note -- Pharmacy Support in Accessing and Distributing Antimicrobials -- Pharmacy Leadership in a Ugandan Regional Referral Hospital -- References -- 7 Change Processes: Multi-Disciplinary Teamwork -- Perceptions of Team Working -- 'We Are a Bridge': The Changing Role of Pharmacy in FPRRH -- References -- 8 The Knowledge Creation and Transfer Mechanism -- Knowledge Transfer and Behaviour Change -- The Contribution of Formal Training in a Mentoring Context -- References -- 9 Conclusions: Capturing, Sustaining, Spreading and Researching Change -- Capturing Change -- Sustaining Change -- Sustainability and Human Resource Augmentation -- Sustainability and Access to Supplies -- Spreading Change -- Policy Transfer Opportunities Within the Hospital -- Researching Change: Ethnography and 'Snagging' -- References -- Appendix: Microbiology Testing at FPRRH -- Sample Acquisition -- Isolate Confirmation -- Identification of Clinical Isolates -- Antibiotic Resistance Profiling -- References -- Index.