BEAMS Project Barriers and enablers to antimicrobial stewardship in Scottish acute care hospitals‌

Project Team

Principal Investigator: Professor Kay Currie 

GCU Co-investigators: Professor Paul Flowers

External Collaborators: Scottish Antimicrobial Prescribing Group (SAPG)

GCU researchers funded by study: Dr Rebecca Laidlaw, Dr Val Ness, Lucyna Gozdzielewska

Funder: Health Protection Scotland

Dates: Completed


Antimicrobial stewardship (AMS), or making appropriate use of antibiotics, is acknowledged internationally as the cornerstone of activities targeted towards addressing the global public health threat of antimicrobial resistance (AMR). In 2008, the Scottish Government introduced an Action Plan with a national programme of work to provide strategic direction towards AMS across all Health Boards. This involved a national network, The Scottish Antimicrobial Prescribing Group, working with Antimicrobial Management Teams in every Health Board to develop guidelines for the appropriate use of antibiotics in hospitals. The implementation of the Scottish AMS programme in the acute hospital sector is the focus of this study, which incorporates the views of Antimicrobial Management Teams, prescribing doctors, clinical pharmacists, and nurses.

Study Aim

The aim of the BEAMS Project is ‘To explore barriers and enablers to implementing anti-microbial stewardship (AMS) in Scottish acute hospitals, identifying those factors which may promote or inhibit effective AMS from a range of stakeholder perspectives.’ Findings from the study will enable policy makers and practitioners to maximise the impact of AMS programmes by focusing on removing barriers to their implementation and strengthening factors which enable the integration of AMS into routine practice.

Research Objectives

To identify barriers and enablers to the implementation of the Scottish AMS programme, as well as participant generated recommendations to strengthen AMS.To utilise Normalisation Process Theory to explain mechanisms which help or hinder the routinisation of AMS into everyday clinical practice.To utilise the Theoretical Domains Framework and Behaviour Change Wheel to identify determinants of individuals’ action which may be amenable to behaviour change interventions.To synthesise findings to generate recommendations to strengthen AMS in NHS Scotland’s acute hospitals.

To our knowledge, this is the first study to adopt three theoretical frameworks from the social sciences to explore implementation of a national AMS programme, across multiple sites, from a range of professional disciplinary perspectives. Findings will have international relevance for all healthcare providers seeking evidence based recommendations to implement or strengthen AMS in the acute hospital sector.