Development of a framework for a proposed antimicrobial usage reporting tool for public sector hospitals
- Authors: Ramjan, Yumna
- Date: 2019
- Subjects: Anti-infective agents
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/43030 , vital:36727
- Description: Background: The inappropriate and unnecessary use of antimicrobials has increased the need to monitor antimicrobial usage so as to identify inappropriate use. In order to support the antimicrobial stewardship (AMS) programme, it is important to quantify the usage of antimicrobials and this can be achieved by promoting the use of AMS utilisation metrics. They are used to measure the progress and efficacy of an AMS programme (Brotherton, 2018).Primary Aim of Research: The primary aim of the research was to develop a framework for a proposed antimicrobial usage reporting tool, which would integrate with various data sources in order to be used by AMS practitioners to optimise antimicrobial usage in the South African public sector hospital setting.Methodology: The study was divided into three phases: a preliminary phase, a developmental phase and a post-developmental phase. The preliminary phase focused on obtaining a comprehensive understanding of the type and nature of the AMS utilisation metrics and subsequently identifying the views on the usage, usefulness and clinical relevance of those AMS utilisation metrics using a quantitative questionnaire, which was conducted among infectious disease specialists, pharmacists, medical prescribers, i.e. prescribers who were not specialists and clinical pathologists employed at tertiary level, public sector hospitals in the Eastern Cape province of South Africa. Consequently, a qualitative semi-structured interview was conducted among healthcare professionals who were involved in the daily implementation of AMS in the workplace. Results obtained from the quantitative component and qualitative component were integrated in order to develop a framework for a proposed antimicrobial usage reporting tool. Results: The Defined Daily Dose (DDD), Prescribed Daily Dose (PDD) and Days of Therapy (DOT) were identified as the most common AMS metrics (Grau et al., 2013). However, the DDD was the only AMS metric currently recommended by the South African National Department of Health (South African National Department of Health, 2017a)and it was the only AMS metric currently being utilised at two of the five research sites in the Eastern Cape province of South Africa. It was identified that data pertaining to antimicrobial usage was available and was being extracted from Rx Solution®. However, the programme did not have the ability of automatically producing the reports, hence, emphasising on the need for an antimicrobial usage reporting tool for South African public sector hospitals. Therefore, the framework for the proposed antimicrobial usage reporting tool would integrate antimicrobial stock management data with the following AMS utilisation metrics: DDD, DOT and PDD, were considered for inclusion in the proposed antimicrobial usage reporting tool. Conclusion: The qualitative findings obtained during the post-developmental phase, therefore, established that although an electronic platform for the purpose of monitoring antimicrobial usage for the South African public sector hospitals was required, there would be many challenges obstructing the implementation of the proposed antimicrobial usage reporting tool.
- Full Text:
- Date Issued: 2019
- Authors: Ramjan, Yumna
- Date: 2019
- Subjects: Anti-infective agents
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/43030 , vital:36727
- Description: Background: The inappropriate and unnecessary use of antimicrobials has increased the need to monitor antimicrobial usage so as to identify inappropriate use. In order to support the antimicrobial stewardship (AMS) programme, it is important to quantify the usage of antimicrobials and this can be achieved by promoting the use of AMS utilisation metrics. They are used to measure the progress and efficacy of an AMS programme (Brotherton, 2018).Primary Aim of Research: The primary aim of the research was to develop a framework for a proposed antimicrobial usage reporting tool, which would integrate with various data sources in order to be used by AMS practitioners to optimise antimicrobial usage in the South African public sector hospital setting.Methodology: The study was divided into three phases: a preliminary phase, a developmental phase and a post-developmental phase. The preliminary phase focused on obtaining a comprehensive understanding of the type and nature of the AMS utilisation metrics and subsequently identifying the views on the usage, usefulness and clinical relevance of those AMS utilisation metrics using a quantitative questionnaire, which was conducted among infectious disease specialists, pharmacists, medical prescribers, i.e. prescribers who were not specialists and clinical pathologists employed at tertiary level, public sector hospitals in the Eastern Cape province of South Africa. Consequently, a qualitative semi-structured interview was conducted among healthcare professionals who were involved in the daily implementation of AMS in the workplace. Results obtained from the quantitative component and qualitative component were integrated in order to develop a framework for a proposed antimicrobial usage reporting tool. Results: The Defined Daily Dose (DDD), Prescribed Daily Dose (PDD) and Days of Therapy (DOT) were identified as the most common AMS metrics (Grau et al., 2013). However, the DDD was the only AMS metric currently recommended by the South African National Department of Health (South African National Department of Health, 2017a)and it was the only AMS metric currently being utilised at two of the five research sites in the Eastern Cape province of South Africa. It was identified that data pertaining to antimicrobial usage was available and was being extracted from Rx Solution®. However, the programme did not have the ability of automatically producing the reports, hence, emphasising on the need for an antimicrobial usage reporting tool for South African public sector hospitals. Therefore, the framework for the proposed antimicrobial usage reporting tool would integrate antimicrobial stock management data with the following AMS utilisation metrics: DDD, DOT and PDD, were considered for inclusion in the proposed antimicrobial usage reporting tool. Conclusion: The qualitative findings obtained during the post-developmental phase, therefore, established that although an electronic platform for the purpose of monitoring antimicrobial usage for the South African public sector hospitals was required, there would be many challenges obstructing the implementation of the proposed antimicrobial usage reporting tool.
- Full Text:
- Date Issued: 2019
A general genetic algorithm for one and two dimensional cutting and packing problems
- Authors: Mancapa, Vusisizwe
- Date: 2007
- Subjects: Packaging -- Data processing , Genetic algorithms , Cutting stock problem , Packing for shipment , Manufacturing processes -- Planning
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: vital:9602 , http://hdl.handle.net/10948/555 , http://hdl.handle.net/10948/d1011727 , Packaging -- Data processing , Genetic algorithms , Cutting stock problem , Packing for shipment , Manufacturing processes -- Planning
- Description: Cutting and packing problems are combinatorial optimisation problems. The major interest in these problems is their practical significance, in manufacturing and other business sectors. In most manufacturing situations a raw material usually in some standard size has to be divided or be cut into smaller items to complete the production of some product. Since the cost of this raw material usually forms a significant portion of the input costs, it is therefore desirable that this resource be used efficiently. A hybrid general genetic algorithm is presented in this work to solve one and two dimensional problems of this nature. The novelties with this algorithm are: A novel placement heuristic hybridised with a Genetic Algorithm is introduced and a general solution encoding scheme which is used to encode one dimensional and two dimensional problems is also introduced.
- Full Text:
- Date Issued: 2007
- Authors: Mancapa, Vusisizwe
- Date: 2007
- Subjects: Packaging -- Data processing , Genetic algorithms , Cutting stock problem , Packing for shipment , Manufacturing processes -- Planning
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: vital:9602 , http://hdl.handle.net/10948/555 , http://hdl.handle.net/10948/d1011727 , Packaging -- Data processing , Genetic algorithms , Cutting stock problem , Packing for shipment , Manufacturing processes -- Planning
- Description: Cutting and packing problems are combinatorial optimisation problems. The major interest in these problems is their practical significance, in manufacturing and other business sectors. In most manufacturing situations a raw material usually in some standard size has to be divided or be cut into smaller items to complete the production of some product. Since the cost of this raw material usually forms a significant portion of the input costs, it is therefore desirable that this resource be used efficiently. A hybrid general genetic algorithm is presented in this work to solve one and two dimensional problems of this nature. The novelties with this algorithm are: A novel placement heuristic hybridised with a Genetic Algorithm is introduced and a general solution encoding scheme which is used to encode one dimensional and two dimensional problems is also introduced.
- Full Text:
- Date Issued: 2007
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