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KMID : 1144320230550010059
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감염과 화학요법
2023 Volume.55 No. 1 p.59 ~ p.68
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Developing Core Elements and Checklist Items for Implementing Antimicrobial Stewardship Programs in Korean General Hospitals: A Modified Delphi Survey
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Cheong Hae-Suk
Park Kyung-Hwa
Kim Bong-Young
Eun Byung-Wook
Kim Hyung-Sook
Kim Yong-Chan
Lee Hyuk-Min
Jeong Su-Jin
Moon Chi-Sook
Kim Shin-Woo
Yoon Young-Kyung
Hwang In-Sun
Park Choon-Seon
Lee Mi-Suk
Kim Hong-Bin
Shin Ji-Yeon
Kwon Ki-Tae
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Abstract
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Background Antimicrobial stewardship programs (ASPs) aim to optimize antimicrobial use by minimizing the spread of antimicrobial resistance. The core elements for implementing ASPs in healthcare facilities have been developed by the World Health Organization, international research group and government agencies of various countries. However, to date, there is no documented core elements for implementation of ASP in Korea. This survey aimed to establish a national consensus on a set of core elements and their related checklist items for the implementation of ASPs in Korean general hospitals.
Materials and Methods The survey was conducted from July 2022 to August 2022 by the Korean Society for Antimicrobial Therapy with support from the Korea Disease Control and Prevention Agency. A literature review was conducted by searching Medline and relevant websites to retrieve a list of core elements and checklist items. These core elements and checklist items were evaluated by a multidisciplinary panel of experts using a structured modified Delphi consensus procedure, using two-step survey included online in-depth questionnaires and in-person meeting.
Results The literature review identified 6 core elements (Leadership commitment, Operating system, Action, Tracking, Reporting, and Education) and 37 related checklist items. Fifteen experts participated in the consensus procedures. Ultimately, all 6 core elements were retained, and 28 checklist items were proposed, all with ≥80% agreement; in addition 9 items were merged into 2 items, 2 items were deleted, and 15 items were rephrased.
Conclusion This Delphi survey provides useful indicators for the implementation of ASP in Korea and suggests national policy improvement about the barriers (e.g., shortage of staffing and financial support) existing in Korea for optimal implementation of ASPs.
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KEYWORD
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Anti-Infective agents, Drug resistance, Microbial, Multidisciplinary communication, Consensus
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