What Resources Do NHS Commissioning Organisations Use to Support Antimicrobial Stewardship in Primary Care in England?

Professional education and public engagement are fundamental components of any antimicrobial stewardship (AMS) strategy. The National Institute for Health and Care Excellence (NICE), Public Health England (PHE), Health Education England (HEE) and other professional organisations, develop and publish resources to support AMS activity in primary care settings. The aim of this study was to explore the adoption and use of education/training and supporting AMS resources within NHS primary care in England. Questionnaires were sent to the medicines management teams of all 209 Clinical Commissioning Groups (CCGs) in England, in 2017. Primary care practitioners in 168/175 (96%) CCGs received AMS education in the last two years. Respondents in 184/186 (99%) CCGs reported actively promoting the TARGET Toolkit to their primary care practitioners; although 137/176 (78%) did not know what percentage of primary care practitioners used the TARGET toolkit. All respondents were aware of Antibiotic Guardian and 132/167 (79%) reported promoting the campaign. Promotion of AMS resources to general practices is currently excellent, but as evaluation of uptake or effect is poor, this should be encouraged by resource providers and through quality improvement programmes. Trainers should be encouraged to promote and highlight the importance of action planning within their AMS training. AMS resources, such as leaflets and education, should be promoted across the whole health economy, including Out of Hours and care homes. Primary care practitioners should continue to be encouraged to display a signed Antibiotic Guardian poster as well as general AMS posters and videos in practice, as patients find them useful and noticeable

Learning by gaming - evaluation of an online game for children

Playing computer games is widely popular among children and teenagers as an entertainment activity; meanwhile, playing computer games also provides a learning opportunity. For example, the rules of the game have to be learned by the player in order to improve his/her performance. Based on that principle, the City eHealth Research Centre (CeRC) developed a web game for 13-15 year olds, whereby the player becomes an investigator who attends the scene of an incident that involves microbes. There are four missions in total, each involving a mystery that the player needs to solve and learning objectives that need to be taught - such as antibiotic resistance and the importance of hygiene. This paper presents the results from a game evaluation that took place between July of 2009, in four UK schools (Glasgow, Gloucester, London), with 129 students; whereby 98% of the students commented positively about playing the game. Subsequently, CeRC has improved the game and developed an interactive educational games portal (www.edugames4all.com) for different age groups of web game enthusiasts

Lyhytelokuvan ohjaus

Insinöörityön tarkoituksena oli hyvistä työtavoista ja yhteisistä pelisäännöistä kertovan Meininki-lyhytelokuvan ohjaaminen käsikirjoitusvaiheesta aina valmiiksi elokuvaksi asti. Elokuva tehtiin ammattikorkeakoulun sisäiseen käyttöön osana Metropolian Meininki -työhyvinvointihanketta ja näytettäväksi sekä vanhoille että uusille opiskelijoille. Elokuvan oli tarkoitus parantaa opiskelijoiden ja henkilökunnan yhteishenkeä ja nostaa esiin keskustelua työpaikan ilmapiiristä ammattikorkeakoulussa huumorin keinoin. Projekti toteutettiin opiskelijavoimin monialaisena yhteistyönä, jonka vetovastuussa oli mediatekniikan koulutusohjelma. Elokuvan käsikirjoitusta muokattiin pitkään. Käsikirjoittaja kirjoitti käsikirjoitustiimin luomat ajatukset kohtauksiksi, minkä jälkeen ohjaaja muokkasi kohtausten ympärille toimintaa. Neljätoistasivuisen käsikirjoituksen myötä alun perin suunnitellun viisiminuuttisen elokuvan kesto venähti yli kymmeneen minuuttiin. Kuvauksia suunniteltiin etukäteen kuvakäsikirjoituksella ja tarkalla aikatauluttamisella. Kuvauspäiviä oli 13, eri puolilla ammattikorkeakoulun pääkaupunkiseudun toimipisteitä. Työryhmässä oli noin kaksikymmentä henkeä, ja avustajineen projektiin osallistui lähes 300 ihmistä. Meininki-elokuvan tuotannolliset tavoitteet asetettiin korkealle ja ne saavutettiin ennenäkemättömällä tavalla. Kuvauspaikkojen lukumäärästä johtuvat suuren kalustomäärän, pitkien kuvauspäivien ja joukkokohtausten organisointiongelmat olivat odotettavissa ja ratkaistavissa suurella työpanoksella. Kuvailmaisusta tuli raikas ja onnistunut. Elokuvaan jäi kuitenkin perustavanlaatuisia ongelmia, jotka liittyvät kiinteästi ohjaajan ydinalueeseen. Käsikirjoitusta olisi pitänyt kiteyttää huomattavasti viimeistään leikkauspöydällä. Amatöörinäyttelijöiden ilmaisun ohjaaminen jäi amatööriohjaajalta hyvin lopputulokseen suuntautuneeksi ja sitä myötä mielenkiinnottomaksi. Projekti saatiin onnistuneesti päätökseen aikataulun puitteissa joskin hieman suuremmalla työpanoksella, kuin mihin projekti oli alussa rajattu. Elokuvasta tuli näyttävä, suunnitellun kaltainen työryhmän yhteinen taidonnäyte, joka oli ohjausryhmän mieleen. Työryhmän toiminta oli ammattimaista ja toimivaa.The purpose of this final year project was to direct a short film called Meininki, starting from screenwriting to producing a complete film as part of an occupational well-being project called Metropolian Meininki. The film was about good working practices and the common rules at the Metropolia University of Applied Sciences and was intended to be shown both to the old and the new students at university of applied sciences. The film was to improve student and staff community spirit and raise discussion about workplace ethics and atmosphere in terms of comedy. The media technology degree program was to be in charge of the project that was executed by students as multidisciplinary co-operation. The film script was edited intensively. The screenwriter wrote the screenplay based on ideas created by the screenwriting team, after which the director edited the scenes action in mind. A fourteen-page script turned into an over ten minute film, instead of a five-minute film that was originally planned. The production was designed in advance with storyboarding and accurate scheduling. There were 13 shooting days in total at various locations at the metropolitan area campuses. The working group consisted approximately of twenty people, and nearly 300 people as a whole took part in the project. The production targets were set high and they were well achieved. Due to the vast number of shooting locations, volume of equipment needed and long shooting days, organizational problems occurred but they could be solved with hard work. Visual expression became fresh and successful. However, the film has fundamental problems, which are closely related to the core areas of expertise of the director. The screenplay should have been shortened much more early on. With an amateur director working with amateur actors, expression became very outcome oriented and, consequently uninteresting. The project was successfully completed within the set timeframe although with a slightly greater amount of work than originally planned. The film turned out showy and presented talent of the work group. This working group worked in a professional, efficient way, and project was executed successfully

Qualitative study using interviews and focus groups to explore the current and potential for antimicrobial stewardship in community pharmacy informed by the Theoretical Domains Framework

Objectives: Community pharmacists and their staff have the potential to contribute to antimicrobial stewardship (AMS). However, their barriers and opportunities are not well understood. The aim was to investigate the experiences and perceptions of community pharmacists and their teams around AMS to inform intervention development. Design: Interviews and focus groups were used to explore the views of pharmacists, pharmacy staff, general practitioners (GPs), members of pharmacy organisations and commissioners. The questioning schedule was developed using the Theoretical Domains Framework which helped inform recommendations to facilitate AMS in community pharmacy. Results: 8 GPs, 28 pharmacists, 13 pharmacy staff, 6 representatives from pharmacy organisations in England and Wales, and 2 local stakeholders participated. Knowledge and skills both facilitated or hindered provision of self-care and compliance advice by different grades of pharmacy staff. Some staff were not aware of the impact of giving self-care and compliance advice to help control antimicrobial resistance (AMR). The pharmacy environment created barriers to AMS; this included lack of time of well-qualified staff leading to misinformation from underskilled staff to patients about the need for antibiotics or the need to visit the GP, this was exacerbated by lack of space. AMS activities were limited by absent diagnoses on antibiotic prescriptions. Several pharmacy staff felt that undertaking patient examinations, questioning the rationale for antibiotic prescriptions and performing audits would allow them to provide more tailored AMS advice. Conclusions: Interventions are required to overcome a lack of qualified staff, time and space to give patients AMS advice. Staff need to understand how self-care and antibiotic compliance advice can help control AMR. A multifaceted educational intervention including information for staff with feedback about the advice given may help. Indication for a prescription would enable pharmacists to provide more targeted antibiotic advice. Commissioners should consider the pharmacists? role in examining patients, and giving advice about antibiotic prescriptions

Developing e-Bug web games to teach microbiology

As a complement to the e-Bug teaching pack, two e-Bug games were developed to provide content that aimed to entertain as well as to educate. A set of agreed learning outcomes (LOs) were provided by the scientific partners of the e-Bug Project and the games were developed using user-centred design techniques (the needs, wants and limitations of the potential game players were assessed at each stage of the design process). The e-Bug games were designed for two age groups: Junior (9\u201312 year olds); and Senior (13\u201315 year olds). A study using focus groups was done to gain an understanding as to the types of games enjoyed by the target users. According to the preliminary study, the Junior Game was developed as a platform game and the Senior Game was developed as a story-based detective game. The Junior Game consists of five levels, each associated with a set of LOs. Similarly, the Senior Game consists of four missions, each comprising five stages using problem-based learning techniques and LOs. In this paper, the process of development for each game is described in detail and an illustration is provided of how each game level or mission addresses the target LOs. Development of the games used feedback acquired from children in four schools across the UK (Glasgow, London and two in Gloucester). The children were selected according to their willingness to participate. European Partners of the e-Bug Project also provided further support, translation and requests for modifications. The knowledge gained of LOs and further evaluation of the games is continuing, and preliminary results are in press. The final versions of the games, translated into 11 European languages, are available online via www.e-bug.eu