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Hospital-based Interventions to Contain Antibiotic Resistance in Low-resource Settings (AIM)

Antibiotic resistance (ABR) is a fast growing problem worldwide, considered as a major threat to public health by the World Health Organization. This 3-week course offers an interdisciplinary and interactive training on relevant aspects of antibiotic resistance and its containment at hospital level. It includes a truncus communis and 3 specific learning tracks on Antibiotic Stewardship, Infection Prevention & Control and Microbiological Surveillance, closely linked key components in the successful containment of antibiotic resistance.
 
The course targets health care professionals from low-resource settings (LRS). Antibiotic resistance is quickly becoming an important public health problem in these contexts because of the high burden of resistant pathogens, the scarce options for diagnosis and therapy, the lack of technical and managerial competences or the lack of adapted guidelines and trainings. The course focuses on hospitals because they concentrate the most ill and vulnerable patients, they are hotbeds of healthcare-acquired infections, act as referral sites for difficult-to-treat infections and host trainees and postgraduate educational programs.  

Mode of study

This course (component) is organized :
- Face-to-face (Antwerpen)

Learning Objectives

After completion of the course, participants should be able to:
  • Develop and implement actions in the containment of ABR in hospitals in LRS, in at least one of the three topics (Antibiotic Stewardship, Microbiological Surveillance and Infection Prevention & Control).
  • Implement basic infection control measures.
  • Co-organize a Hospital Infection Prevention & Control and Antibiotic Stewardship Committee.
  • Communicate, teach and train at the level of the expected audience.  
 
In addition, participants to the Antibiotic Stewardship track should be able to:
  • Implement and teach principles of rational use of antibiotics at patient and hospital level.
  • Collect/interpret quantitative/qualitative data on antibiotic use and antibiotic susceptibility results.
  • Translate ABR-data into antibiotic treatment guidelines and a local antibiotic policy.
  • Implement and evaluate an antibiotic policy at hospital level.
 
Participants to the Infection Prevention & Control track should be able to:
  • Select common disinfectants and antiseptics for each application.
  • Apply and monitor appropriate sterilization and disinfection methods.
  • Set-up hospital-based implementation plans (hand hygiene, hospital waste managementā€¦).
  • Apply extended precautions (contact, droplet and airborne).
  • Apply basics of good nursing practices.
 
Participants to the Microbiological Surveillance track should be able to:
  • Perform quality assured clinical bacteriology.
  • Collect, interpret and report antibiotic resistance data for individual patients.
  • Aggregate laboratory-based data into passive surveillance data and report them efficiently.
  • Sample, work-up and report selected specimens as support for infection control.

Content

The course focuses on the three main components of ABR-containment in a low-resource hospital setting as well as on their interactions: Antibiotic Stewardship, Infection Prevention & Control and Microbiological Surveillance. It consists of:
 
A truncus communis addressing topics common to the three themes:
  • Key pathogens and antibiotics
  • Health care associated infections
  • Key aspects in Infection Prevention & Control
  • Interventions to contain ABR, including Hospital Infection Prevention & Control Committee and Antibiotic Stewardship Committee
  • Principles of Antibiotic Stewardship
  • Carrousel: exercises on blood sampling, handwashing and wound care
  • Blood & other cultures: indications, sampling and transport
  • SOP, poster, writing for clarity
 
Specific modules on themes of particular relevance for each of the three disciplines:
 
Antibiotic Stewardship track:
  • (Ir)rational use of antibiotics
  • Gathering/understanding antibiotic use data
  • From antimicrobial susceptibility testing to surveillance report
  • Translation antimicrobial susceptibility testing into guideline & policy
  • Prescriber and patient perspective
  • Over and under access of antibiotics
 
Microbiological Surveillance track:
  • Working-up cultures in the laboratory
  • Reading and interpreting antimicrobial susceptibility testing results
  • Communication individual laboratory results
  • Aggregate laboratory data to surveillance report
  • Environmental sampling
  • Sterilization: packing, labeling & use of containers
 
Infection Prevention & Control track:
  • Essential requirements facility, including waste management
  • Antiseptics/disinfectants
  • Reusable material & equipment
  • Surfaces
  • Extended precautions: contact, droplet, airborne
  • Invasive devices and care bundles

Teaching and learning methods

The course offers a mixture of lectures, hands-on sessions (including bench- and practical exercises and a carrousel), case discussions, data analysis, role plays and a debate. It contains joint sessions and sessions tailored to each of the three topics.
 
The role-plays, exercises and group work (organized as a Hospital Committee with participants from the different tracks) allow for maximal interdisciplinary interaction, mirror real-life in the hospital, offer the opportunity to exchange ideas and skills and allow to build-up the synergism required for successful action.
 
During the course, as a personal project, each participant will develop, present and defend an Antibiotic Resistance (ABR)-containment plan for his/her facility in front of an expert committee.
The objectives of the personal project are the following:
    • define the main problems and challenges in ABR containment in your hospital;
    • list ideas and activities for ABR containment in your hospital;
    • develop a personal intervention plan, clarifying how these activities will be implemented;
    • implement a limited set of activities in your hospital after the course.
As part of the application candidates are asked to submit a short document (1,000 words maximum) including:
    • a short description of the main problems and challenges related to containment of ABR in their structure;
    • an action plan with a limited set of activities to contain ABR;
    • activities should be pragmatic, feasible, affordable, measurable and possibly implemented within a reasonable timeframe in their structure. The action plan does not have to include a long list of activities: we would like candidates to focus on a realistic set of activities;
    • the expected results.
 

Assessment

Summative assessment of the participants is based on a multiple choice test at the end of the course (40%), a personal project (40%) and a group work (20%).
After successful completion of the course students receive an ITM Credit Certificate.

Admission requirements

The course aims in particular at health care workers (medical doctors, nursing staff, clinical officers, pharmacists, biomedical scientists and laboratory staff) working in hospital facilities in LRS and involved in Antibiotic Stewardship, Infection Prevention & Control and/or Microbiological Surveillance activities.
 
  • Participants should be holders of a (para)medical university degree of minimum 240 ECTS credits or equivalent and have two years of relevant professional experience. Exceptions to the degree requirement are possible based on level and relevance of professional experience.
 
  • Proficiency in the course language is required. Candidates who are non-native speakers of the course language or whose language of previous instruction is not the same as the course language, must be able to prove their language proficiency with a certificate from a recognized institution (required level for English: TOEFL paper-based 580, computer-based 230, Internet-based 88 or IELTS 6.5. (ITM Toefl Code 7727))

Selection criteria

Candidates will be selected based on the following criteria:
 
  • Curriculum Vitae
  • Motivation letter
  • Commitment letter from the home institution
  • Personal project
  • Working in hospital
  • Working in low-resource setting. Cluster applications of candidates from the same hospital are encouraged

Contact

File Holder: Jan Jacobs
Co-ordinator (s): Jorgen Stassijns
Secretary: Judith Vervisch
aim@itg.be
Tel: +32(0)32476300

Credits

The course study load is equivalent to 5 ECTS credits (European Credit Transfer and accumulation System credits).