Antimicrobial Stewardship Programs at Pediatric Centres Across Canada: Implementation and Characteristics
Bibliographic record
Abstract
Background. Antimicrobial Stewardship Programs (ASPs) consist of coordinated interventions designed to improve and measure appropriate antimicrobial use. ASPs became a Required Organizational Practice (ROP) instituted by Accreditation Canada in 2013 and pediatric programs are in various stages of ASP development across Canada. In this audit we assessed the implementation of ASPs by determining the characteristics of ASPs at academic pediatric centres across Canada. Methods. We utilized REDCap to conduct an electronic survey of 16 children's hospitals in Canada using a list of personal contacts at each academic pediatric centre, as well as the Paediatric Investigators Collaborative Network on Infections in Canada (PICNIC). The survey of ASP physicians and pharmacists included questions on the details of the institution's ASP, metrics collected and measured by the institution, and process measures of the ASP. Institutional demographic information was also collected. Results. We received 16 completed surveys representing 11 hospitals (institution response rate 69%). Respondents included Infectious Diseases physicians (n = 9, 56%), pharmacists (n = 5, 31%) and Infectious Diseases trainees (n = 2, 13%). Of the 11 institutions, 8 had established ASPs. The most common ASP strategies used hospital wide were clinical guidelines (n = 9) and order sets (n = 9). All sites had critical care units (NICU and PICU), and 8 sites had specific ASP strategies in both areas. Ten sites monitored antimicrobial usage using a combination of Days Of Therapy (n = 6, 55%), cost (n = 7, 64%) and resistance patterns (n = 8, 73%). Nine sites had systems for documenting ASP recommendations and/or documenting adherence to ASP recommendations. Only 5 sites (45.4%) were documenting these performance measures. Conclusion. The results of our survey suggest that most academic pediatric hospitals in Canada have established ASPs that are using a variety of strategies. While all established ASPs monitor antimicrobial usage, there is significant variability in data collected and metrics reported. There is a necessity for both a description of the best metrics to measure the impact pediatric ASPs are having; and publications of these findings for benchmarking and quality improvement initiatives. Disclosures. All authors: No reported disclosures.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".