Questionnaire about handling of gram-negative multidrug-resistant organisms (GNMDRO) and antibiotic management structures

  1. General data

1.1Who operates the hospital?*

Please select one of the following options:

☐ Public operator

☐Nonprofit operator (church, Red Cross)

☐For-profit operator

1.2 How many beds does your ward/ICU have?*

______

1.3 How many beds on your ward/ICU are in single-bed rooms?*

______

1.4 Who records healthcare-associated infections as part of KISS surveillance?

Please select one or multiple options from the list.

☐Ward physician

☐Ward nurse

☐Hygiene specialist (not based on your ward)

☐Physician responsible for hygiene (not based on your ward)

☐Hospital hygienist (not based on your ward)

☐Other: ______

1.4.1 You selected “ward physician” in question 1.4. How much time per week is required for recording infections (investigating results/patient visits/documentation/data entry)?

Please give the average amount of time in hours per week.*

______

1.4.2 You selected “ward nurse” in question 1.4.How much time per week is required for recording infections (investigating results/patient visits/documentation/data entry)?

Please give the average amount of time in hours per week.*

______

1.4.3 You selected “hygiene specialist” in question 1.4.How much time per week is required for recording infections (investigating results/patient visits/documentation/data entry)?

Please give the average amount of time in hours per week.*

______

1.4.4 You selected “physician responsible for hygiene” in question 1.4.How much time per week is required for recording infections (investigating results/patient visits/documentation/data entry)?

Please give the average amount of time in hours per week.*

______

1.4.5 You selected “hospital hygienist” in question 1.4.How much time per week is required for recording infections (investigating results/patient visits/documentation/data entry)?

Please give the average amount of time in hours per week.*

______

  1. Multidrug-resistant pathogens: Structural data

2.1 Where is microbiological diagnostic performed?

Please select one of the following options.

☐In the hospital’s own laboratory

☐In an external laboratory

☐Other: ______

4. Antibiotic use [prescription, antibiotic stewardship, surveillance]

4.1 Who is responsible for the prescription of antibiotics?

4.1.1 Who is responsible for starting courses of antibiotics?

Please select one or more options from the list.

☐Ward physician, independently

☐Ward physician, with senior physician’s approval

☐Senior physician

☐Infectious disease specialist/ microbiologist/ infection control specialist/ ABS team

☐Other: ______

4.1.2 Who is responsible for stopping courses of antibiotics?

Please select one or more options from the list.

☐Ward physician, independently

☐Ward physician, with senior physician’s approval

☐Senior physician

☐Infectious disease specialist/ microbiologist/ infection control specialist/ ABS team

☐Other: ______

4.2 Are “antibiotics rounds” (defined as meetings to specifically discuss antibiotic prescriptions) performed on your ward?

Yes, regularly (e.g. weekly) / Yes, when possible / No
For all patients with infections / ☐ / ☐ / ☐
For all patients with antibiotic treatment / ☐ / ☐ / ☐
In the case of proven MDROs / ☐ / ☐ / ☐
“difficult” cases (e.g. in the view of ward physicians) / ☐ / ☐ / ☐
View of microbiological results / ☐ / ☐ / ☐
Others* / ☐ / ☐ / ☐

4.2a Other*:*

Please answer this question only if other kinds of antibiotics rounds take place other than as described in question 4.2.

______

4.3 Are individual therapy guidelines available for antibiotics on your ward?*

Please select one or more options from the list.

☐Yes, electronically

☐Yes, written and on ward

☐Yes, written and in pocket format

☐Yes, written, but without access (e.g. only available through senior physician; out of print)

☐No

☐Don’t know

4.4 Are certain antibiotics available on your ward only according to certain regulations?

Please select one or more options from the list.

☐Yes, depending on the substance (e.g. new, expensive, a reserve antibiotic, etc.)

☐Yes, depending on the patient (allergic, low kidney function, etc.)

☐Yes, depending on indicators (perioperative prophylaxis, resistance, etc.)

☐No

☐Don’t know

4.4.1 Which antibiotics or antibiotic groups are only available on your ward according to certain regulations?

Please answer this question only if limited antibiotic prescription applies to certain substances. (see question 4.4)

Please select one or more options from the list

☐Carbapeneme

☐Cephalosporine, 3rd generation or higher

☐Daptomycin

☐Fluorchinolone

☐Linezolid

☐Vancomycin

☐Colistin (polymyxin e)

☐Others (single substances or substance groups, e.g.ertapenem, etc.)

4.5 Does the ward (e.g. through head physician or ward physician) have access to ward-based, current, annual or semiannual statistics on antibiotic resistance?*

Please select one or more options from the list

☐Yes

☐No

☐Don’t know

4.6 Does your ward get regular feedback on antibiotics?*

Please select one or more options from the list

☐Yes, regarding cost

☐Yes, regarding use

☐No

4.7 What units are used to provide feedback on antibiotic use?*

Please select one or more options from the list.

☐Amount (packages or in grams)

☐Amount in reference to cases or patient-days

☐Defined daily dose (DDD) in reference to cases or patient-days

☐Recommended daily dose (RDD) in reference to cases or patient-days

☐Don’t know

4.8 Does your hospital take part in a German national antibiotic use surveillance project?*

Please select one or more options from the list.

☐Yes, SARI/SARI-light

☐Yes, ADKA-IF-antibiotics surveillance project

☐No

☐Don’t know

☐Yes, other: ______

4.9 Does your microbiology lab take part in an established pathogen surveillance system?*

Please select one or more options from the list.

☐Yes, SARI

☐Yes, ARS

☐Yes, PEG

☐Not yet, but in planning

☐No

☐Don’t know

☐Other: ______

4.10 Does the microbiology lab provide information or feedback about MDROs or antibiotic resistance on your ward, according to §23 of the German Infection Protection Act (IfSG)?

Please select one or more options from the list.

☐Yes, monthly

☐Yes, quarterly

☐Yes, semiannually

☐Yes, annually

☐Yes, upon request

☐No