P-985. Telementoring Program to Strengthen Antimicrobial Stewardship Programs (ASP) in Latin American Hospitals

TL;DR

A telementoring program improved antimicrobial stewardship in Latin American hospitals, especially in for-profit institutions and those with long-term programs.

Contribution

A telementoring program was developed and evaluated for its impact on antimicrobial stewardship training and implementation in Latin American hospitals.

Findings

For-profit hospitals showed higher ASP development scores compared to non-for-profit hospitals.

ASP scores significantly improved after the telementoring program, especially in education and safety climate.

Private funding and ASP continuity for over five years were significant predictors of ASP success.

Abstract

The ECHO Institute, in collaboration with PROAnet and Pfizer, developed a telementoring program to strengthen ASP in Latin American hospitals. This study assessed its impact on training outcomes and ASP development.

A quasi-experimental, multicenter study was conducted across 80 hospitals in 10 countries. Hospitals performed self-assessments using the WHO qualitative and PROAnet quantitative (0-100 scale) tools, before and after intervention. A multivariate regression model identified institutional variables associated with ASP baseline levels. Between March and December 2024, 31 virtual sessions were held including 18 educational and 13 case-based sessions. Learning outcomes were evaluated through post-session surveys using Moore’s levels and 5-point Likert scales. Additionally, barriers and enablers to ASP implementation were also analyzed.

For-profit hospitals demonstrated higher scores than non-for-profits in ASP development (57.7 vs. 49.5; p=0.034), clinical guideline implementation (68.8 vs. 50.6; p=0.006), and antimicrobial prescription strategies (67.3 vs. 58.2; p=0.049). Multivariate analysis identified private funding (p=0.04) and continuous ASP implementation for >5 years (p< 0.01) as significant predictor of higher ASP development. Among the 73 hospitals with both baseline and post-study assessments, the overall ASP score showed a significantly increase (53.1 vs 64.0; mean difference 10.9; 95% CI 8.0 to 13.7; p< 0.0001), with notable improvements in Education, Training, and Safety Climate (39.0 vs 54.5; mean difference 15.4; 95% CI 11.3 to 19.5; p< 0.0001). Of the 2,166 participants, 34% were physicians, 24% pharmacists, 18% microbiologists, and 24% other specialists. Moore’s levels indicated high perceived relevance (87%), increased knowledge acquisition (97%), knowledge application (93%), ASP strategy implementation or modification (87%), and satisfaction (81%). A total of 22 enablers and 21 barriers to ASP implementation were identified.

Institutional funding and ASP continuity were key determinants of success. The telementoring initiative significantly enhanced training and antimicrobial stewardship strategies, emphasizing the need for sustained institutional support and structured education.

Ana C. Barbosa de Lima, Dr., Pfizer Inc.: Grant/Research Support Jorge Mera, Dr., Abbott Diagnostics: Grant/Research Support|AbbVie: Grant/Research Support|AbbVie: I am part of their speaker bureau and have received honoraria|Cepheid: Grant/Research Support|Gilead: Grant/Research Support