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Title: Management of antibiotic use and infection-related issues in clinical practice
Author: Alahmadi , Yaser Masuod
Awarding Body: Queen's University Belfast
Current Institution: Queen's University Belfast
Date of Award: 2013
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The research presented in this thesis explores antibiotic use and strategies to manage infection related issues within the hospital setting. In Chapter 2, the prevalence of the use of antibiotics and of HAl in hospitalised patients within Northern Ireland was explored using a point prevalence study design. This research provided details on the rate of antibiotic use and prevalence af HAI in the study sites as well as helped in the identification of targets for quality improvement of antibiotic prescribing and allowed the explanation of potential risk factors of HAl. In Chapter 3, the impact of an enhanced antibiotic stewardship programme on reducing MRSA and Clostridium difficile infection (CDI) in hospitalised patients was evaluated using segmented regression analysis within an interrupted time series. This work also involved evaluating the impact of antibiotic stewardship on the use of hi gh-risk antibiotics in the study setting. This study showed that the restriction of high-risk antibiotics contributed to both a reduction in their use and a reduction in the incidence of MRSA and CDJ in the study site hospital. Chapter 4 includes a report on the evaluation of the clinical and cost implications of blood culture contamination (Bee) within the hospital setting utilising a case-control study, comparing case samples with control samples. Length of hospital stay and total hospital resource utilisation were the main outcome measures. The results of this study indicated that BCC increased the length of hospital stay and incurred significant additional hospital costs including needless antibiotic use and extra laboratory tests. Finally, in Chapter 5, a prospective investigation was performed to evaluate the impact of an educational intervention in tackling the problem of BCC in an intensive care unit (leU). This study confinns the benefit (lower BeC rates) of continuous training and education on the proper technique for taking blood cultures in critically ill, ICU patients.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available