Diagnostic stewardship in clinical practice

Introduction

Diagnostic stewardship is a systematic approach to the effective use of the microbiology laboratory in clinical practice in order to deliver safer, more effective and efficient patient care by appropriate and timely generation of clinically relevant microbiological data.

The primary aim is to benefit the patient and ensure that they receive the correct treatment. Proper use of diagnostics also helps to understand the prevalence of pathogens in general, and AMR in particular. An appropriate approach to testing generates accurate and representative AMR surveillance data to inform local and national treatment guidelines and AMR control strategies. Furthermore, data resulting from its systematic use can contribute to pathogen-focused AMR surveillance such as the the World Health Organization’s (WHO’s) Global Antimicrobial Resistance Surveillance System (GLASS).

This module will introduce diagnostic stewardship with a focus on the essential structures and practices in both clinical and laboratory settings, and the role of administrators in enabling effective collaboration and data collection.

After completing this module, you will be able to:

• describe the roles in a diagnostic stewardship programme
• understand the principles of taking appropriate clinical samples
• appreciate the range of laboratory techniques available for bacterial isolation, pathogen identification and AST
• understand how microbiology can be appropriately reported to clinicians
• understand factors affecting bacteriology laboratory turnaround times and reporting
• promote good working relationships between laboratories and clinicians for effective diagnostic stewardship
• understand diagnostic stewardship in surveillance at national and international levels
• understand how to introduce a diagnostic stewardship programme.