Development and validation of measures to assess prevention and control of AMR in hospitals

Mindy Flanagan; Rangaraj Ramanujam; Jason Sutherland; Thomas Vaughn; Daniel Diekema; Bradley N. Doebbeling

doi:10.1097/MLR.0b013e31803bb48b

Development and validation of measures to assess prevention and control of AMR in hospitals

Mindy Flanagan, Rangaraj Ramanujam, Jason Sutherland, Thomas Vaughn, Daniel Diekema, Bradley N. Doebbeling

Research output: Contribution to journal › Article › peer-review

8 Scopus citations

Abstract

BACKGROUND: The rapid spread of antimicrobial resistance (AMR) in the US hospitals poses serious quality and safety problems. Expert panels, identifying strategies for optimizing antibiotic use and preventing AMR spread, have recommended hospitals undertake efforts to implement specific evidence-based practices. OBJECTIVE: To develop and validate a measurement scale for assessing hospitals's efforts to implement recommended AMR prevention and control measures. STUDY DESIGN: Surveys were mailed to infection control professionals in a national sample of 670 US hospitals stratified by geographic region, bedsize, teaching status, and VA affiliation. SUBJECTS: Four hundred forty-eight infection control professionals participated (67% response rate). METHODS:: Survey items measured implementation of guideline recommendations, practices for AMR monitoring and feedback, AMR-related outcomes (methicillin-resistant Staphylococcus aureus prevalence and outbreaks [MRSA]), and organizational features. ĝ€ Derivationĝ€ and ĝ€ validationĝ€ samples were randomly selected. Exploratory factor analysis was performed to identify factors underlying AMR prevention and control efforts. Multiple methods were used for validation. RESULTS:: We identified 4 empirically distinct factors in AMR prevention and control: (1) practices for antimicrobial prescription/use, (2) information/resources for AMR control, (3) practices for isolating infected patients, and (4) organizational support for infection control policies. The Prevention and Control of Antimicrobial Resistance scale was reliable and had content and construct validity. MRSA prevalence was significantly lower in hospitals with higher resource/information availability and broader organizational support. CONCLUSIONS:: The Prevention and Control of Antimicrobial Resistance scale offers a simple yet discriminating assessment of AMR prevention and control efforts. Use should complement assessment methods based exclusively on AMR outcomes.

Original language	English (US)
Pages (from-to)	537-544
Number of pages	8
Journal	Medical care
Volume	45
Issue number	6
DOIs	https://doi.org/10.1097/MLR.0b013e31803bb48b
State	Published - Jun 2007
Externally published	Yes

Keywords

AMR
Factor analysis
MRSA
Measurement development
Organizational

ASJC Scopus subject areas

Public Health, Environmental and Occupational Health

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10.1097/MLR.0b013e31803bb48b

Cite this

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title = "Development and validation of measures to assess prevention and control of AMR in hospitals",

abstract = "BACKGROUND: The rapid spread of antimicrobial resistance (AMR) in the US hospitals poses serious quality and safety problems. Expert panels, identifying strategies for optimizing antibiotic use and preventing AMR spread, have recommended hospitals undertake efforts to implement specific evidence-based practices. OBJECTIVE: To develop and validate a measurement scale for assessing hospitals's efforts to implement recommended AMR prevention and control measures. STUDY DESIGN: Surveys were mailed to infection control professionals in a national sample of 670 US hospitals stratified by geographic region, bedsize, teaching status, and VA affiliation. SUBJECTS: Four hundred forty-eight infection control professionals participated (67% response rate). METHODS:: Survey items measured implementation of guideline recommendations, practices for AMR monitoring and feedback, AMR-related outcomes (methicillin-resistant Staphylococcus aureus prevalence and outbreaks [MRSA]), and organizational features. ĝ€ Derivationĝ€ and ĝ€ validationĝ€ samples were randomly selected. Exploratory factor analysis was performed to identify factors underlying AMR prevention and control efforts. Multiple methods were used for validation. RESULTS:: We identified 4 empirically distinct factors in AMR prevention and control: (1) practices for antimicrobial prescription/use, (2) information/resources for AMR control, (3) practices for isolating infected patients, and (4) organizational support for infection control policies. The Prevention and Control of Antimicrobial Resistance scale was reliable and had content and construct validity. MRSA prevalence was significantly lower in hospitals with higher resource/information availability and broader organizational support. CONCLUSIONS:: The Prevention and Control of Antimicrobial Resistance scale offers a simple yet discriminating assessment of AMR prevention and control efforts. Use should complement assessment methods based exclusively on AMR outcomes.",

keywords = "AMR, Factor analysis, MRSA, Measurement development, Organizational",

author = "Mindy Flanagan and Rangaraj Ramanujam and Jason Sutherland and Thomas Vaughn and Daniel Diekema and Doebbeling, {Bradley N.}",

year = "2007",

month = jun,

doi = "10.1097/MLR.0b013e31803bb48b",

language = "English (US)",

volume = "45",

pages = "537--544",

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T1 - Development and validation of measures to assess prevention and control of AMR in hospitals

AU - Flanagan, Mindy

AU - Ramanujam, Rangaraj

AU - Sutherland, Jason

AU - Vaughn, Thomas

AU - Diekema, Daniel

AU - Doebbeling, Bradley N.

PY - 2007/6

Y1 - 2007/6

N2 - BACKGROUND: The rapid spread of antimicrobial resistance (AMR) in the US hospitals poses serious quality and safety problems. Expert panels, identifying strategies for optimizing antibiotic use and preventing AMR spread, have recommended hospitals undertake efforts to implement specific evidence-based practices. OBJECTIVE: To develop and validate a measurement scale for assessing hospitals's efforts to implement recommended AMR prevention and control measures. STUDY DESIGN: Surveys were mailed to infection control professionals in a national sample of 670 US hospitals stratified by geographic region, bedsize, teaching status, and VA affiliation. SUBJECTS: Four hundred forty-eight infection control professionals participated (67% response rate). METHODS:: Survey items measured implementation of guideline recommendations, practices for AMR monitoring and feedback, AMR-related outcomes (methicillin-resistant Staphylococcus aureus prevalence and outbreaks [MRSA]), and organizational features. ĝ€ Derivationĝ€ and ĝ€ validationĝ€ samples were randomly selected. Exploratory factor analysis was performed to identify factors underlying AMR prevention and control efforts. Multiple methods were used for validation. RESULTS:: We identified 4 empirically distinct factors in AMR prevention and control: (1) practices for antimicrobial prescription/use, (2) information/resources for AMR control, (3) practices for isolating infected patients, and (4) organizational support for infection control policies. The Prevention and Control of Antimicrobial Resistance scale was reliable and had content and construct validity. MRSA prevalence was significantly lower in hospitals with higher resource/information availability and broader organizational support. CONCLUSIONS:: The Prevention and Control of Antimicrobial Resistance scale offers a simple yet discriminating assessment of AMR prevention and control efforts. Use should complement assessment methods based exclusively on AMR outcomes.

AB - BACKGROUND: The rapid spread of antimicrobial resistance (AMR) in the US hospitals poses serious quality and safety problems. Expert panels, identifying strategies for optimizing antibiotic use and preventing AMR spread, have recommended hospitals undertake efforts to implement specific evidence-based practices. OBJECTIVE: To develop and validate a measurement scale for assessing hospitals's efforts to implement recommended AMR prevention and control measures. STUDY DESIGN: Surveys were mailed to infection control professionals in a national sample of 670 US hospitals stratified by geographic region, bedsize, teaching status, and VA affiliation. SUBJECTS: Four hundred forty-eight infection control professionals participated (67% response rate). METHODS:: Survey items measured implementation of guideline recommendations, practices for AMR monitoring and feedback, AMR-related outcomes (methicillin-resistant Staphylococcus aureus prevalence and outbreaks [MRSA]), and organizational features. ĝ€ Derivationĝ€ and ĝ€ validationĝ€ samples were randomly selected. Exploratory factor analysis was performed to identify factors underlying AMR prevention and control efforts. Multiple methods were used for validation. RESULTS:: We identified 4 empirically distinct factors in AMR prevention and control: (1) practices for antimicrobial prescription/use, (2) information/resources for AMR control, (3) practices for isolating infected patients, and (4) organizational support for infection control policies. The Prevention and Control of Antimicrobial Resistance scale was reliable and had content and construct validity. MRSA prevalence was significantly lower in hospitals with higher resource/information availability and broader organizational support. CONCLUSIONS:: The Prevention and Control of Antimicrobial Resistance scale offers a simple yet discriminating assessment of AMR prevention and control efforts. Use should complement assessment methods based exclusively on AMR outcomes.

KW - AMR

KW - Factor analysis

KW - MRSA

KW - Measurement development

KW - Organizational

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SN - 0025-7079

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EP - 544

JO - Medical care

JF - Medical care

IS - 6

ER -

Development and validation of measures to assess prevention and control of AMR in hospitals

Abstract

Keywords

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