Implementation Of 5s PDCA Methodology to Assess and Improve Antimicrobial Stewardship Practices in A Tertiary Trauma Care Centre In Tamilnadu, India

Abstract

Background: Antimicrobial effectiveness is in jeopardy because of the worldwide rapid development of bacterial resistance. The crisis of antimicrobial resistance has been ascribed to the overuse and abuse of these drugs as well as the lack of innovation by the pharmaceutical industry, thereby necessitating the requirement for antimicrobial preservation. This study focuses on assessing the rationality and effectiveness of the prescription of antimicrobials. Objective: The study mainly focuses on the assessment of antimicrobial stewardship using 5S PDCA (Plan, Do, Check and Act) methodology by observing the antimicrobial prescribing practices, comparing them to established hospital standards, and identifying appropriate elements that are contributing to antimicrobial stewardship program deviance. Methods: A prospective observational study using 5S PDCA methodology to assess antimicrobial stewardship was conducted in the department of orthopedics and plastic surgery in a major trauma care centre in Tamil Nadu, India over a period of one year. Result: In our study, implementation of the 5S PDCA methodology showed a marked reduction of deviations in antibiotic practices. The antimicrobial usage pattern has been improved and the study helped in updating institutional antibiotic policy. The major problems that are creating a subsequent deviation from the proper conductance of antimicrobial stewardship programs have been sorted out by the study effectively. Conclusion: The study concludes that there is a need for antimicrobial stewardship and the application of 5S PDCA methodology is beneficial as the tool for improving every step in reducing the antimicrobial practice deviations and improving the patient outcomes. The problems identified have been sorted out and improvement strategies have been implemented which have helped in improving the patient outcomes. Correspondingly, inappropriateness of antibiotic usage was reduced in sort phase from 53% to 25%, set in order phase from 48% to 17 %, shine phase from 45% to 16%, standardize phase from 25% to 15% and sustain phase from 38% to 18%.