Barriers to implementing antimicrobial stewardship programmes in three Saudi hospitals: Evidence from a qualitative study
Objective This study aims to explore antimicrobial stewardship programmes (ASPs) team members’ perspectives regarding the factors influencing the adoption and implementation of these programmes in Saudi hospitals. Methods A qualitative study based on face-to-face semi-structured interviews with healthcare professionals involved in Antimicrobial Stewardship Programmes and activities across three Ministry of Health (MOH) hospitals in Saudi Arabia (n = 18). Interviews were also conducted with two representatives of a general directorate of health affairs in a Saudi region and two representatives of the Saudi MOH (n = 4) between January and February 2017. Results Despite the existence of a national strategy to implement ASPs in Saudi MOH hospitals, their adoption and implementation remain low. Hospitals have their own antimicrobial stewardship policies but adherence to these is poor. ASP team members highlight that the lack of enforcement of policies and guidelines from MOH and hospital administration is a significant barrier to ASPs adoption and implementation. Other barriers include disintegration of teams, poor communication, lack of recruitment/ shortage of ASP team members, lack of education and training, and lack of health information technology (IT). Physicians’ fears and concerns in relation to liability are also a barrier to their adoption of ASPs. Conclusion This is the first qualitative study exploring barriers to ASPs adoption and implementation in Saudi hospitals from the perspectives of ASP team members. Formal endorsement of ASPs from MOH, and hospitals’ enforcement of policies and provision of human and health IT resources would improve the adoption and implementation of ASPs in Saudi hospitals.