CwPAMS 1.5 Brighton-Lusaka Health Link Partnership
The partnership focused on Developing optimal antimicrobial stewardship (AMS) capacity and practice in rural and peri-urban healthcare settings in Zambia
The project was delivered by staff from the University Hospitals Sussex NHS Foundation Trust; Brighton and Sussex Medical School in the UK and the University of Zambia and University Teaching Hospital in Zambia.
Lead partners of the CwPAMS 1.5 Brighton-Lusaka Health Link Partnership consisted of:
University of Sussex; and
Hospital Pharmacy Association Zambia
The partnership focused on Developing optimal antimicrobial stewardship (AMS) capacity and practice in rural and peri-urban healthcare settings in Zambia.
A Hub and Spoke Model (HSM) was used across sectors to augment peripheral services/practices by centralizing key resources. Their project goal was to assess the feasibility of whether the use of HSM could enhance Antimicrobial Stewardship (AMS) practice improvement across public hospitals.
Methodology
- Multi-method design
- Hub Hospital: University Teaching Hospital (UTH) established AMS
capacity – AMS Charts - Spoke Hospitals (Pilot sites) included:
– Kabwe Central Hospital (Central Provinces)
– Kitwe Central Teaching Hospital (Copperbelt Province)
Phase 1 | Phase 2 | Phase 3 |
Baseline antimicrobial utilisation (GPPS) and AMS practice assessment (CDC checklist) in spoke hospitals | AMS and Infection Prevention and Control (IPC) training & team capacity building of multidisciplinary healthcare workers (HCWs), experience sharing and mentoring visits by Hub, iterative peer learning cycles (‘Plan-Do-Study-Act’) at spoke hospitals by Hub mentors
| Monitoring and follow-up assessment of interventions in spoke hospitals |
Key Achievements:
- A catalysed self-sustaining model was rolled out to develop provincial AMS hubs at Kabwe and Kitwe hospitals
- Multidisciplinary AMS teams were established and operationalised in spoke hospitals
- Improved knowledge and practice of AMS and IPC in spoke hospitals (Pre-test = 74%; post-test average score = 84%)
- Alignment of AMS priorities in spoke hospitals e.g. rational antibiotic use, adherence to guidelines, inter-professional and inter-institutional collaboration
- Hand rub production units, including upskilling of staff to locally produce alcohol-based hand rub for IPC
- Point prevalence survey (PPS) data reporting, feedback, and dissemination
- 5 PPS reports generated: (Pre and Post PPS)
Kitwe 2, Kabwe 2 and Chipata 1 - Presented at the Pharmaceutical Society of Zambia Scientific Conference –June, 2022
- Successful stakeholders’ engagement and meeting
- Antimicrobial drug chart developed
- Established a 6th handrub manufacturing unit in Kabwe
Training Materials Outcomes:
- Antimicrobial Stewardship Training for HealthCare Workers in Zambia
- Standard Operating Procedure Handbook for Hand rub Production and Hand Hygiene in the Hospital
Training successes:
- Conducted AMS Training: 3 Hospitals AMS Committees
Chipata Central Hospital- April 2022
Kitwe Central Hospital –March 2022
Kabwe Central Hospital – February 2022 - Total Trained 42 AMS Multidisciplinary Members
- Average score Pre-Test 74% and Post-Test 84%
