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Strengthening Antibiotics Stewardship At Mowbray Maternity – Neonatal Unit
Objective To assess antimicrobial usage, prescription practices, sensitivity patterns, hand hygiene (HH) practices and adherence to antibiotic stewardship principles in the neonatal unit at Mowbray Maternity Hospital (MMH). Study design: Mixed method observational study was done at MMH. A point of p...
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| Format: | Thesis |
| Language: | English |
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Department of Paediatrics and Child Health
2024
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| _version_ | 1867613226149085184 |
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| access_status_str | Open Access |
| author | Mkony, Martha |
| author2 | Rhoda, Natasha Raygaan |
| author_browse | Mkony, Martha Rhoda, Natasha Raygaan |
| author_facet | Rhoda, Natasha Raygaan Mkony, Martha |
| author_sort | Mkony, Martha |
| collection | Thesis |
| description | Objective To assess antimicrobial usage, prescription practices, sensitivity patterns, hand hygiene (HH) practices and adherence to antibiotic stewardship principles in the neonatal unit at Mowbray Maternity Hospital (MMH). Study design: Mixed method observational study was done at MMH. A point of prevalence survey to assess antibiotic stewardship and HH audits were conducted using the WHO tools in two phases, a baseline in December 2020 and post-intervention from March to May 2021. Results: 246 Neonatal unit patient folders were reviewed between December 2020 and May 2021. At baseline, compliance with treatment guidelines was 90% which improved to 100% post-intervention. We found 37(15.0%) babies were on antibiotics, with 64.9 % of those on first-line antibiotics (Access group). Using multivariate logistic regression, extremely preterm infants were more likely to be on antibiotics with an odds ratio of 11, which was statistically significant. We found eight organisms (18.9%), which included one Carbapenem-resistant enterococci -Klebsiella pneumoniae. For HH, a total of 444 opportunities were observed. Moment 5 had the lowest overall mean compliance of (57.4%), which was statistically significant with a p-value =0.0172. The overall HH compliance was 83.7% at baseline and 80.9% post-intervention; however, this was not statistically significant (p-value = 0.909). Conclusion: Strict adherence to treatment guidelines and good HH are essential factors for the good antibiotic stewardship seen at the MMH neonatal unit. This was reflected by low antibiotic usage, good HH compliance and low HAI rate. Further improvement requires ongoing HH audits and training, especially focusing on HH moment 5, after touching the patient's surroundings. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/39673 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:32:46.693Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2024 |
| publishDateRange | 2024 |
| publishDateSort | 2024 |
| publisher | Department of Paediatrics and Child Health |
| publisherStr | Department of Paediatrics and Child Health |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/39673 Strengthening Antibiotics Stewardship At Mowbray Maternity – Neonatal Unit Mkony, Martha Rhoda, Natasha Raygaan Neonatology Objective To assess antimicrobial usage, prescription practices, sensitivity patterns, hand hygiene (HH) practices and adherence to antibiotic stewardship principles in the neonatal unit at Mowbray Maternity Hospital (MMH). Study design: Mixed method observational study was done at MMH. A point of prevalence survey to assess antibiotic stewardship and HH audits were conducted using the WHO tools in two phases, a baseline in December 2020 and post-intervention from March to May 2021. Results: 246 Neonatal unit patient folders were reviewed between December 2020 and May 2021. At baseline, compliance with treatment guidelines was 90% which improved to 100% post-intervention. We found 37(15.0%) babies were on antibiotics, with 64.9 % of those on first-line antibiotics (Access group). Using multivariate logistic regression, extremely preterm infants were more likely to be on antibiotics with an odds ratio of 11, which was statistically significant. We found eight organisms (18.9%), which included one Carbapenem-resistant enterococci -Klebsiella pneumoniae. For HH, a total of 444 opportunities were observed. Moment 5 had the lowest overall mean compliance of (57.4%), which was statistically significant with a p-value =0.0172. The overall HH compliance was 83.7% at baseline and 80.9% post-intervention; however, this was not statistically significant (p-value = 0.909). Conclusion: Strict adherence to treatment guidelines and good HH are essential factors for the good antibiotic stewardship seen at the MMH neonatal unit. This was reflected by low antibiotic usage, good HH compliance and low HAI rate. Further improvement requires ongoing HH audits and training, especially focusing on HH moment 5, after touching the patient's surroundings. 2024-05-21T13:03:22Z 2024-05-21T13:03:22Z 2023 2024-05-21T12:30:10Z Thesis / Dissertation Masters MPhil http://hdl.handle.net/11427/39673 eng application/pdf Department of Paediatrics and Child Health Faculty of Health Sciences |
| spellingShingle | Neonatology Mkony, Martha Strengthening Antibiotics Stewardship At Mowbray Maternity – Neonatal Unit |
| thesis_degree_str | Master's |
| title | Strengthening Antibiotics Stewardship At Mowbray Maternity – Neonatal Unit |
| title_full | Strengthening Antibiotics Stewardship At Mowbray Maternity – Neonatal Unit |
| title_fullStr | Strengthening Antibiotics Stewardship At Mowbray Maternity – Neonatal Unit |
| title_full_unstemmed | Strengthening Antibiotics Stewardship At Mowbray Maternity – Neonatal Unit |
| title_short | Strengthening Antibiotics Stewardship At Mowbray Maternity – Neonatal Unit |
| title_sort | strengthening antibiotics stewardship at mowbray maternity neonatal unit |
| topic | Neonatology |
| url | http://hdl.handle.net/11427/39673 |
| work_keys_str_mv | AT mkonymartha strengtheningantibioticsstewardshipatmowbraymaternityneonatalunit |