Development of a web-based application to improve data collection of antimicrobial utilization in the public health care system in South Africa

Figures & data

Figure 1. Workflow for paper-based data collection (based on 181 patient surveys)

Box 1. Content of the questionnaire to assess the usability of the developed app

The app was easy to use I think that I would need the support of a technical person to be able to use the app I found the app unnecessarily complex I found the various functions in this system were well integrated I thought there was too much inconsistency in this system I would imagine that most people would learn to use this app very quickly I found the app very difficult to use I felt very confident using the app I needed to learn a lot of things before I could get going with this app It enables me to accomplish task more quickly compared to the forms Overall, I find this product useful in PPS surveys How much time did you take to survey one patient file with the app How much time did you take to survey one patient file with the form

Table 1. Variables for which incorrect data were observed

Variable	Number of incorrect entries	Refined in app
No consent – contradiction	6	No
HIV negative patients on HAART – contradiction	1	Yes
Antibiotic and route of administration – contradiction	2	No
Culture and sensitivity results ordered – unknown option	16	Yes
No culture taken, but culture results available in file – contradiction	2	Yes
Antimicrobial name for Surgical Prophylaxis – empty field	1	Yes

Figure 2. Process for app-based data collection tool

Table 2. Feedback on the usability of the APP (n = 15)

Questions	Strongly agree	Agree	Disagree	Strongly disagree
The app was easy to use	4	11	0	0
I think that I would need the support of a technical person to be able to use the app	0	0	15	0
I found the app unnecessarily complex	0	0	14	1
I found the various functions in this system were well integrated	2	12	1	0
I thought there was too much inconsistency in this system	0	1	9	5
I would imagine that most people would learn to use this app very quickly	0	15	0	0
I found the app very difficult to use	0	0	15	0
I felt very confident using the app	10	5	0	0
I needed to learn a lot of things before I could get going with this app	12	3	0	0
It enables me to accomplish task more quickly compared to the paper-based forms	12	2	0	1
Overall, I find this product useful in point prevalence surveys	11	4	0	0
How much time did you take to survey one patient file with the app	5 to 10 minutes	11 to 20 minutes	21 to 30 minutes	More than 30 minutes
Response from data collectors to this question	2	10	3	0
How much time did you take to survey one patient file with the paper based form	5 to 10 minutes	11 to 20 minutes	21 to 30 minutes	More than 30 minutes
Response from data collectors to this question	0	5	10	0

Table

	VARIABLES:
1	Patient consent
2	Patient age
3	Gender
4	Employment status
5	Transferred in from another facility or not
6	History of hospitalization in the past 90 days
7	History of antimicrobial use in the past 90 days
8	Was the patient on any catheter
9	Was the patient on any intubation
10	Does the patient have malaria
11	HIV status of the patient
12	Patient on HAART or not
13	Tb status of the patient
14	Was the patient malnourished or not
15	Diagnoses
16	Additional Surgery
17	Patient on any Antimicrobials
18	Antimicrobials used including dose
19	Hospital staff who prescribed the antimicrobial
20	Route of administration
21	Prescribed as Prophylaxis or Treatment
22	Was Prophylaxis Medical or Surgical
23	Duration of Antimicrobials for Surgical Prophylaxis
24	Type of Infection where Antimicrobials where prescribed for Treatment
25	If Culture and Sensitivity test (CST) was ordered before initiation of empiric antimicrobials
26	If Culture and Sensitivity (CST) result was available in the file
27	Name of organisms cultured
28	If treatment modified as per CST results
29	If IV antibiotics switched to Oral antibiotics if GIT was stable
30	Was this item prescribed from SA-EDL
31	If there were any missed doses
32	If missed doses were due to out of stock issues
33	If the item was written on the drug sheet
34	If item was prescribed from SA-EDL
35	If the item was prescribed in INN name

Data availability statement

The data that support the findings of this study are available from the corresponding author, BG, upon reasonable request.