Antimicrobial resistance is rising in healthcare facilities and is driven, primarily, by inappropriate antimicrobial use in these settings. There has been increasing interest in developing and implementing hospital-based antimicrobial stewardship programs (ASPs) to reduce and improve antibiotic use and to slow the emergence and spread of antimicrobial resistant pathogens.
Checklists outlining core elements of ASPs are a practical way for healthcare providers to assess current clinical practices and ensure best antibiotic use practices are followed. Previous ASP checklists have successfully led to optimized antibiotic use and improved healthcare; however, most ASP checklists have been geared towards implementation in high-income countries such as those in North America, Europe, and Australia.
Researchers at the Center for Disease Dynamics, Economics & Policy (CDDEP), in collaboration with researchers at the Université de Lorraine, the Qatar Foundation, and the World Innovation Summit for Health (WISH), aimed to fill this gap by developing a checklist feasible to adopt globally in all healthcare facilities including those in low- and middle-income countries. The result was the Checklist for Hospital Antimicrobial Stewardship Programming (CHASP).
CHASP was based on an expert panel’s review of published scientific research and existing checklists including the US Centers for Disease Control and Prevention’s Core Elements of Hospital Antibiotic Stewardship Programs, and was published in the journal Clinical Microbiology and Infection.
The seven core components of CHASP address:
- Senior hospital management and leadership
- Accountability and responsibility
- Access to infection management professionals
- Education and practical training
- Continuous monitoring and surveillance of stewardship activities
- Reporting and sharing of antimicrobial resistance and antimicrobial monitoring data
- Actions aimed at responsible antimicrobial use
Following development, the checklist was tested in 12 Leading Health Systems Network hospitals across nine countries including low-income countries.
The checklist and complete results of the pilot testing are published in a report titled, “Global Core Standards For Hospital Antimicrobial Stewardship Programs: International Perspectives and Future Directions” and is available for download (above) and online here.
Additionally, a paper titled, “Developing core elements and checklist items for global hospital antimicrobial stewardship programmes: a consensus approach,” outlines the checklist development process and was published in Clinical Microbiology and Infection and is available for download (above) and online here.
Photo Credit: Ribero Pombo, M.H. et al.