title: A National Survey of Critical Care Physicians' Knowledge, Attitudes, and Perceptions of Antimicrobial Stewardship Programs.
abstract: OBJECTIVE
  Antimicrobial stewardship is a process designed to optimize antimicrobial therapy by ensuring patients get the right antimicrobials at the right dose and at the right time. Antimicrobial stewardship programs (ASPs) are increasingly being implemented in health care institutions, are required by some accreditation bodies, and have the potential for maximum impact in intensive care units (ICUs). We administered a survey to critical care physicians across Canada to better understand their knowledge, attitudes, and perceptions on the utility of ASPs in improving patient care.
  
  
  METHODS
  We distributed a Web-based survey to physicians who attend in Canadian ICUs. Respondents were identified through the membership lists of multiple critical care organizations. Content validity, utility, clarity, and test-retest reliability were evaluated prior to distribution. Survey items assessed ASP knowledge, attitudes, and experiences. Attitudes toward ASPs were assessed on a 5-point Likert-type scale.
  
  
  RESULTS
  The survey was completed by 185 physicians, with a response rate of 29% (n = 185/634) for all physicians contacted. A majority (74%) of respondents reported that there was at least 1 component of an ASP at their institution. Most (86%) respondents agreed or strongly agreed that the patients in their ICU benefit from an ASP, with 81% reporting the ASP increases their knowledge of appropriate antimicrobial use in the ICU setting. Only 11% of respondents reported they felt that time spent interacting with the ASP team was an inefficient use of their time, and only 7% expressed concern that the ASP negatively affected their autonomy.
  
  
  CONCLUSIONS
  Based on our survey results, Canadian intensivists are supportive of antimicrobial stewardship in ICUs and feel that ASPs provide a valuable service to both patients and clinicians.
authors.affiliation: Mount Sinai Hospital, Toronto, Canada msteinberg@mtsinai.on.ca.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Steinberg
authors.affiliation: University Health Network, Toronto, Canada Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.
authors.forename: Linda D
authors.initials: LD
authors.lastname: Dresser
authors.affiliation: Division of Infectious Diseases, University of Toronto, Toronto, Canada Sunnybrook Health Sciences Centre, Toronto, Canada Institute for Clinical Evaluative Sciences, Toronto, Canada Department of Medicine, University of Toronto, Toronto, Canada.
authors.forename: Nick
authors.initials: N
authors.lastname: Daneman
authors.affiliation: Keenan Research Centre in the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.
authors.forename: Orla M
authors.initials: OM
authors.lastname: Smith
authors.affiliation: University Health Network, Toronto, Canada.
authors.forename: Andrea
authors.initials: A
authors.lastname: Matte
authors.affiliation: Sunnybrook Health Sciences Centre, Toronto, Canada.
authors.forename: Nicole
authors.initials: N
authors.lastname: Marinoff
authors.affiliation: Mount Sinai Hospital, Toronto, Canada Institute for Clinical Evaluative Sciences, Toronto, Canada Department of Medicine, University of Toronto, Toronto, Canada.
authors.forename: Chaim M
authors.initials: CM
authors.lastname: Bell
authors.affiliation: Mount Sinai Hospital, Toronto, Canada University Health Network, Toronto, Canada Division of Infectious Diseases, University of Toronto, Toronto, Canada Department of Medicine, University of Toronto, Toronto, Canada.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Morris
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001291:Attitude of Health Personnel; D002170:Canada; D002983:Clinical Competence; D003141:Communicable Diseases / Q000188:drug therapy; D003422:Critical Care; D017723:Drug Utilization Review; D019983:Guideline Adherence; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010820:Physicians / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D015203:Reproducibility of Results
chemical_list: D000900:Anti-Bacterial Agents
keywords: antimicrobial stewardship; attitudes; critical care; knowledge; perceptions; survey