Thesis:

An assessment of antimicrobial stewardship status in Kapsabet county referral hospital, Nandi county, Kenya

The pertinent need for antimicrobial stewardship (AMS) has been orchestrated by the rising rates of antimicrobial resistance (AMR). Antimicrobial stewardship programs play a pivotal part in encouraging the rational usage of antimicrobials within hospital settings. Assessing the key indicators of Antimicrobial Stewardship Program (ASP) in healthcare facility settings is a practical way of identifying the drivers and barriers of AMS. This study assessed the status of antimicrobial stewardship in Kapsabet County Referral Hospital in Nandi County. Objectively, it assessed health care workers awareness; drivers as well as barriers for effective antimicrobial stewardship program at Kapsabet County Referral Hospital in Nandi County. By use of a descriptive, cross-sectional study design, the study employed stratified random sampling, targeting medical officers, pharmacists and clinical officers. Study approvals were secured from National Commission for Science, Technology and Innovation, MKU research committee and Kapsabet County Referral Hospital. A total of 63 respondents filed the structured questionnaires and checklist that were distributed to the sampled population. Quantitative and qualitative data was collected and analyzed. It was determined that the antimicrobial stewardship status at Kapsabet County Referral Hospital was not well developed, with 54% of the respondents rating the AMS program as below average. The core interventions that drive AMS program were partially implemented with an average of 1.86 and a standard deviation of 0.63, despite health care workers demonstrating awareness and an understanding of antimicrobial stewardship with an average of 2.59 and a standard deviation of 0.49. Poor communication on antimicrobial resistance, poor leadership and insufficient resources were cited as the most common barriers for effective implementation of antimicrobial stewardship. The study concluded that even though the antimicrobial stewardship is not well-developed, the health care workers demonstrated awareness, with optimal antimicrobial usage through documentation of drug dosage, duration and indication as the main driver of AMS program at the facility. This study recommends the strengthening of the AMS program at Kapsabet County Referral Hospital through the enhancement of AMS awareness; strengthening antimicrobial optimization usage; and leadership commitment to promote sustainability of the antimicrobial stewardship program in a health facility setting.