Eileen's Policy Paper

Health care facilities and providers are becoming more concerned with the increasing rate of bacterial resistance and the impact it has on the population. Researchers and health care providers are joining together to help decrease the rates of bacterial resistance in the population by looking for the sources that have led to the bacterial resistance. Areas to focus on bacterial resistance are the patients and the health care provider. There are suggestions that the misuse and noncompliance of antibiotics have increased the rates of bacterial resistance in hospitals (3). Unfortunately, the resistant bacteria are more difficult to treat, and may be more expensive because the patient is required to take particular drugs that are less available (1).
Noncompliance towards antibiotic treatment has been reported all over the world. There are many issues for the reason why people are noncompliant such as: country, dosage regimen, age, attitudes toward doctors and antibiotics (4). Therefore, it is critical that there are policies that are put into place to help decrease that antibiotic misuse and the noncompliance in patients to ultimately help control and eventually decrease the bacterial resistance.
Whether it’s treating symptoms for a cough, not taking medications at the correct time, or discontinuing the medication before the completion date; medication misuse has often been overlooked by the patient and has many times has gone unnoticed by the health care provider.
The misuse of medications may increase the probability of bacterial resistance (2). Unfortunately, nearly one third of all patients do not complete their antibiotic medications. The lack of compliance can produce inadequate or unsuccessful treatment of antibiotics. This places people at risk for continued disease as well as preventing accurate assessment and treatment (5).
Policies should be set into place to help minimize the medication misuse and the patient noncompliance thus reducing the bacterial resistance in the population.
The first policy that should be set in the Neonatal Intensive Care Unit at Sanford Hospital in Sioux Falls, South Dakota, is that health care providers must improve their communication between themselves and the patient. This will help promote an accurate assessment and treatment care plan, as well as encourage patients to ask questions they may have about the diagnosis and treatment (5).
Secondly, the policy will state that the physicians need to prescribe a medication with which the patient is mostly likely to comply as well as being the simplest but yet effective medication. This will decrease the difficulties in administering the medications, but will help increase the likelihood of the patient expressing his or her concerns or attitude towards the medication that is going to be prescribed to them, resulting in a higher rate of compliance (5).
In the last part of the policy it will inform the physicians to help encourage the patients to call or email if he or she has any questions about the medication they are being prescribed. This will help increase compliance if questions, concerns, or problems may arise while taking the prescription.
There will be a mandatory five hour training for all direct care faculty members in the Neonatal Intensive Care Unit at Sanford Hospital. During the training time the policy will be further discussed and clarified if questions should arise. The training will also give tips and provide information about how the health care provider can improve his or her communication between themselves and the patient. The direct care faculty members who perform the training paid overtime for the five hours while in training. For the indirect care faculty members, the training is highly recommended but not mandatory. However, they will receive bonus pay if they attend the five hour training.
Faculty members might argue that they do not have the time in their schedule for the training. Therefore, over the course of 1 month there will be numerous trainings scheduled at various times throughout the day. If the faculty member still has difficulty attending one of the scheduled time options, they will need to discuss their reason of not being able to attend with their supervisor. The supervisor will then make further arrangements or will have a special time when the faculty member can perform the training that best fits into his or her schedule.
By enforcing the above policy, there will hopefully be a reduction in the occurrence of bacteria resistances in the population. The policy will help clarify, educate, and help patients become more aware of the medications they are taking, thus it may reduce the amount of noncompliance and the misuse of the prescription medications. Ultimately, the policy will help contain and minimize the rate of bacterial resistance that has grown here, at Sanford Hospital.


Byarugaba, D. K. "Antimicrobial Resistance in Developing Countries and Responsible Risk Factors." 6 May 2004. Makerere University. 19 Sept. 2008 <http://www.sciencedirect.com>.

Davies. "Does Increased Use of Antibiotics Result in Increased Antibiotic Resistance?" Clinical of Infectious Diseases 39 (2004): 18-19.

Larson, Elaine L., Dave Quiros, Tara Giblin, and Susan Lin. "Relationship of Antimicrobial Control Policies and Hospital and." American Journal of Critical Care 16 (2007): 110-120.

Pechère, Jean-Claude, Dyfrig Hughes, Przemyslaw Kardas, and Giuseppe Cornaglia. "Non-compliance with Antibiotic Therapy for Acute Community Infections: A Global Survey." International Journal of Antimicrobial Agents 29 (2007): 245-53.

Winnick, Sheldon, David O. Lucas, Adam L. Hartman, and David Toll. "How Do You Improve Compliance?" Pediatrics 115 (2005): Ee718-724.

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