A nursing and midwifery training program in Kathmandu on antimicrobial resistance and stewardship and infection prevention and control: a qualitative and quantitative outcomes and process evaluation
BackgroundLow- and middle-income countries (LMICs) are disproportionately affected by antimicrobial resistance (AMR). Nurses and midwives are essential to a holistic approach to AMR stewardship (AMS) and IPC within LMICs.Objective(1) Adapt AMS and IPC training programs and practice guidelines for co...
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Frontiers Media S.A.
2025-01-01
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| author | Jamuna Tamrakar Sayami Rakchya Amatya Kshitij Karki Deepak Bajracharya Basudha Shrestha Sreenidhi Srinivasan Tyler Prentiss Anita Shallal Marcus Zervos Katie Latack Linda Kaljee |
| author_facet | Jamuna Tamrakar Sayami Rakchya Amatya Kshitij Karki Deepak Bajracharya Basudha Shrestha Sreenidhi Srinivasan Tyler Prentiss Anita Shallal Marcus Zervos Katie Latack Linda Kaljee |
| author_sort | Jamuna Tamrakar Sayami |
| collection | DOAJ |
| description | BackgroundLow- and middle-income countries (LMICs) are disproportionately affected by antimicrobial resistance (AMR). Nurses and midwives are essential to a holistic approach to AMR stewardship (AMS) and IPC within LMICs.Objective(1) Adapt AMS and IPC training programs and practice guidelines for community- and hospital-based nurses and midwives in Nepal; (2) pilot and conduct training outcome and process evaluations.DesignA one-day training was developed through partnerships between Henry Ford Health and nursing and midwifery organizations and teaching facilities in Nepal. Quantitative outcome and process evaluations were conducted. Qualitative process evaluation interviews were conducted with purposefully selected trainees.Setting(s)Trainees worked in healthcare facilities in Kathmandu Valley.ParticipantsA total of 126 nurses and midwives participated in the training and the quantitative evaluation. Eighteen trainees participated in the process evaluation interviews.MethodsThe 10-module program was adapted from AMS and IPC materials from the World Health Organization and the Nepal Ministry of Health and Population, and curricula from previous AMS studies in Nepal. Key outcomes were AMS and IPC knowledge, and decision-making about empirical dispensing of antibiotics. The process evaluation focused on training content, integration into practice, implementation barriers, and recommendations for dissemination. Quantitative data analysis included descriptive and bivariate analysis. Qualitative data analysis included coding, searches, review of coded texts, and identification of patterns and themes.ResultsAMS and AMR knowledge increased at immediate [1.40 (1.06–1.74) CI 95%] and six-month post-training [0.71 (0.35–1.08) CI 95%]. IPC knowledge also increased at immediate [0.79 (0.55–1.03) CI 95%] and six-month post-training [0.72 (0.49–0.96) CI 95%]. At immediate post-training, an increasing number of respondents indicated that they would not dispense antibiotics for adults [14.74% (4.88, 24.60%) CI 95%] and children [8.13% (−1.88, 18.14%) CI 95%] with fever and sore throats, and for non-pregnant women with burning sensation when urinating [10.69% (0.68%, 20.71%) CI 95%]. Process evaluation data indicated positive responses to the training content and relevancy to practice.ConclusionThe AMS-IPC training increased knowledge and decreased intentions for dispensing antibiotics. Participants provided concrete examples of implementation of learnings into practice. Trainings will be adapted to address identified content needs and challenges to implementation. |
| format | Article |
| id | doaj-art-2d2ca83435274b5a8bd69db448eb9c2f |
| institution | Kabale University |
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| publishDate | 2025-01-01 |
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| spelling | doaj-art-2d2ca83435274b5a8bd69db448eb9c2f2025-01-23T06:56:40ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-01-011310.3389/fpubh.2025.14973351497335A nursing and midwifery training program in Kathmandu on antimicrobial resistance and stewardship and infection prevention and control: a qualitative and quantitative outcomes and process evaluationJamuna Tamrakar Sayami0Rakchya Amatya1Kshitij Karki2Deepak Bajracharya3Basudha Shrestha4Sreenidhi Srinivasan5Tyler Prentiss6Anita Shallal7Marcus Zervos8Katie Latack9Linda Kaljee10National Centre for Health Profession Education, Kathmandu, NepalGroup for Technical Assistance, Lalitpur, NepalGroup for Technical Assistance, Lalitpur, NepalGroup for Technical Assistance, Lalitpur, NepalKathmandu Model Hospital, Kathmandu, NepalHenry Ford Health, Global Health Initiative, Detroit, MI, United StatesHenry Ford Health, Global Health Initiative, Detroit, MI, United StatesHenry Ford Health, Division of Infectious Diseases, Detroit, MI, United StatesHenry Ford Health, Division of Infectious Diseases, Detroit, MI, United StatesHenry Ford Health, Public Health Sciences, Detroit, MI, United StatesHenry Ford Health, Global Health Initiative, Detroit, MI, United StatesBackgroundLow- and middle-income countries (LMICs) are disproportionately affected by antimicrobial resistance (AMR). Nurses and midwives are essential to a holistic approach to AMR stewardship (AMS) and IPC within LMICs.Objective(1) Adapt AMS and IPC training programs and practice guidelines for community- and hospital-based nurses and midwives in Nepal; (2) pilot and conduct training outcome and process evaluations.DesignA one-day training was developed through partnerships between Henry Ford Health and nursing and midwifery organizations and teaching facilities in Nepal. Quantitative outcome and process evaluations were conducted. Qualitative process evaluation interviews were conducted with purposefully selected trainees.Setting(s)Trainees worked in healthcare facilities in Kathmandu Valley.ParticipantsA total of 126 nurses and midwives participated in the training and the quantitative evaluation. Eighteen trainees participated in the process evaluation interviews.MethodsThe 10-module program was adapted from AMS and IPC materials from the World Health Organization and the Nepal Ministry of Health and Population, and curricula from previous AMS studies in Nepal. Key outcomes were AMS and IPC knowledge, and decision-making about empirical dispensing of antibiotics. The process evaluation focused on training content, integration into practice, implementation barriers, and recommendations for dissemination. Quantitative data analysis included descriptive and bivariate analysis. Qualitative data analysis included coding, searches, review of coded texts, and identification of patterns and themes.ResultsAMS and AMR knowledge increased at immediate [1.40 (1.06–1.74) CI 95%] and six-month post-training [0.71 (0.35–1.08) CI 95%]. IPC knowledge also increased at immediate [0.79 (0.55–1.03) CI 95%] and six-month post-training [0.72 (0.49–0.96) CI 95%]. At immediate post-training, an increasing number of respondents indicated that they would not dispense antibiotics for adults [14.74% (4.88, 24.60%) CI 95%] and children [8.13% (−1.88, 18.14%) CI 95%] with fever and sore throats, and for non-pregnant women with burning sensation when urinating [10.69% (0.68%, 20.71%) CI 95%]. Process evaluation data indicated positive responses to the training content and relevancy to practice.ConclusionThe AMS-IPC training increased knowledge and decreased intentions for dispensing antibiotics. Participants provided concrete examples of implementation of learnings into practice. Trainings will be adapted to address identified content needs and challenges to implementation.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1497335/fullantimicrobial stewardshipinfection prevention and controlprogram evaluationSouth AsiaNepal |
| spellingShingle | Jamuna Tamrakar Sayami Rakchya Amatya Kshitij Karki Deepak Bajracharya Basudha Shrestha Sreenidhi Srinivasan Tyler Prentiss Anita Shallal Marcus Zervos Katie Latack Linda Kaljee A nursing and midwifery training program in Kathmandu on antimicrobial resistance and stewardship and infection prevention and control: a qualitative and quantitative outcomes and process evaluation Frontiers in Public Health antimicrobial stewardship infection prevention and control program evaluation South Asia Nepal |
| title | A nursing and midwifery training program in Kathmandu on antimicrobial resistance and stewardship and infection prevention and control: a qualitative and quantitative outcomes and process evaluation |
| title_full | A nursing and midwifery training program in Kathmandu on antimicrobial resistance and stewardship and infection prevention and control: a qualitative and quantitative outcomes and process evaluation |
| title_fullStr | A nursing and midwifery training program in Kathmandu on antimicrobial resistance and stewardship and infection prevention and control: a qualitative and quantitative outcomes and process evaluation |
| title_full_unstemmed | A nursing and midwifery training program in Kathmandu on antimicrobial resistance and stewardship and infection prevention and control: a qualitative and quantitative outcomes and process evaluation |
| title_short | A nursing and midwifery training program in Kathmandu on antimicrobial resistance and stewardship and infection prevention and control: a qualitative and quantitative outcomes and process evaluation |
| title_sort | nursing and midwifery training program in kathmandu on antimicrobial resistance and stewardship and infection prevention and control a qualitative and quantitative outcomes and process evaluation |
| topic | antimicrobial stewardship infection prevention and control program evaluation South Asia Nepal |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1497335/full |
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