Optimizing antibiotic usage in hospitals: a qualitative study of the perspectives of hospital managers.

摘要: Summary Background Antibiotic optimization in hospitals is an increasingly critical priority the context of proliferating resistance. Despite emphasis on doctors, optimizing antibiotic use within requires understanding how different stakeholders, including non-prescribers, influence practice and change. Aim This study was designed to understand Australian hospital managers' perspectives antimicrobial resistance, managing governance, negotiating clinical vis-a-vis managerial priorities. Methods Twenty-three managers three participated qualitative semi-structured interviews Australia 2014 2015. Data were systematically coded thematically analysed. Findings The findings demonstrate, from a perspective: (1) competing demands that can hinder prioritization governance; (2) ineffectiveness audit monitoring methods limit rationalization for change; (3) limited education feedback doctors; (4) management-directed change processes are constrained by perceived absence ‘culture accountability’ amongst doctors. Conclusion Hospital report considerable structural interprofessional challenges actualizing governance. These place as lower other issues management confronted with settings, emphasize importance stewardship (AMS) programmes engage addressing barriers