Abstract:
Hospital-acquired antimicrobial-resistant infections are a leading cause of neonatal
mortality in South African (SA) neonatal intensive care units (NICU). There is an
urgent need for NICU Antibiotic Stewardship Programs (ASP). We describe the development
of an international Train-the-Trainer (TTT) NICU-ASP mentoring program for
SA pharmacists. A partnership between the South Africa Antimicrobial Stewardship in 2019. A baseline assessment of four SA NICUs was done to guide the development
of a TTT NICU-ASP mentoring of SA pharmacists utilizing the existing workforce. The
program included bilateral site visits. Pre-post surveys were used to assess SA
mentee's NICU experiences, barriers to clinical pharmacy services and confidence to
train additional pharmacists in NICU ASP. Four mentees from private (n = 1) and public
hospitals (n = 3) completed a 2-week TTT NICU-ASP in the US that included; education,
patient care rounds, role-playing, peer-to-peer sessions and behavioral
interventions followed by ongoing support and mentoring by SAASP mentors. None
of the hospitals had pharmacists participating in daily patient care rounds or had multidisciplinary
NICU-ASPs due to lack of NICU trained pharmacists and dedicated time
for ASP. Post surveys showed improved confidence to train additional pharmacists in
NICU-ASP. Subsequently, these SA mentees provided NICU-ASP education to over
700 health care professionals and trained six additional pharmacists in NICU-ASP.
Mentors and mentees developed a comprehensive NICU ASP toolkit for ongoing
training of additional pharmacists. A new research collaboration between TTT NICUASP
mentors, mentees and physician members of the South Africa National Neonatal
Sepsis Task Force has formed and the first national NICU-ASP study is underway in
12 hospitals. Shared leadership between U.S. and SA mentors led to developing a
TTT NICU-ASP for pharmacists tailored to existing resources and local needs.
