The ultimate team

Having healthcare professionals with a diversity of experience and skills, not necessarily all infection specialists, on the antimicrobial management team to work on stewardship activities is important.

If you had to decide who was essential (versus desirable) to have on your team, whom would you pick from the following list?

• Senior Surgeon
• Consultant Microbiologist and/or an Infectious Disease Physician
• Chief Nurse /Senior Nurse
• Senior and/or infection/antibiotic pharmacist
• Epidemiologist/statistician/data handler

A comprehensive programme with communication and collaboration between multiple disciplines is key to the success of antimicrobial stewardship.

Although open to some debate, the core (essential) members of an antimicrobial stewardship team should include a microbiologist or infectious disease physician and a clinical pharmacist with antibiotic/infectious disease training.

Additional members will help the team function optimally and include:

• microbiologist or infectious disease physician (depending on which specialty is missing from the core team and the local hospital human resource)
• information systems specialist
• infection control professional
• hospital epidemiologist
• senior nurse

Depending on the nature of the antimicrobial stewardship problems where you work, and how the team plans to tackle those problems with the resources available, it may be desirable to have other healthcare professionals, such as a general physician and/or surgeon, a junior doctor and a patient representative, on the team.

The program should function under the auspices of an established quality assurance/clinical governance and/or patient safety program and collaborate closely with the hospital infection prevention and control and pharmacy/therapeutics committees.

Collaboration, consensus and engagement with hospital administrators, medical staff leaders and local providers are also crucial to the success of antimicrobial stewardship. A lack of engagement and poor relationships between the antimicrobial management team and surgeons is suggested in the Week 1 scenario video and is likely to have contributed to the subsequent crisis.

In Week 5, the science, role and importance of behaviour-change in antimicrobial stewardship will be considered. To learn more about behaviour change techniques, check out the free BSAC FutureLearn courses – Utilising Social Science and Behaviour Change in Antimicrobial Stewardship Programmes: Improving Healthcare and Tackling Antimicrobial Resistance: A Social Science Approach.