1. What is the Global-PPS?
2. What are the objectives of the Global-PPS?
3. Why should I participate in the Global-PPS?

1. What is the Global-PPS?

The Global Point Prevalence Survey of Antimicrobial Consumption is a web-based tool that enables hospitals and healthcare facilities to measure and analyse their own antimicrobial prescribing practices.

There are three modules in which you can participate: the basic inpatient module, the healthcare-associated module (which is an extension of the inpatient module), and the outpatient module.

2. What are the objectives of the Global-PPS?

The main aim of the Global-PPS is to empower hospitals to measure and benchmark the quality of antimicrobial use, using the method of a point prevalence survey (PPS). Furthermore, we aim to aid hospitals in identifying targets to improve the quality of their antimicrobial prescribing, to prevent intervention-related Healthcare-Associated Infections, to help design hospital interventions to promote prudent antimicrobial use and to ultimately improve patient health.

3. Why should I participate in the Global-PPS?

Participating in the (Global-PPS) offers several key benefits. First, it provides healthcare institutions with valuable data on their antimicrobial use patterns, enabling them to benchmark their practices against other hospitals globally. This data-driven insight helps institutions identify trends, gaps, and opportunities for improvement in their antimicrobial stewardship programs, leading to more effective strategies for reducing resistance and optimizing patient outcomes. Additionally, the Global-PPS promotes collaboration and knowledge-sharing among healthcare institutions worldwide. By participating, hospitals can choose to contribute to a larger body of research that informs global policy on antimicrobial use, helping to combat the growing threat of antimicrobial resistance. All necessary materials to conduct the survey and access to the data entry platform are freely available, making it accessible to any institution that wishes to participate.

1. What do I need to prepare to conduct the Global-PPS?
2. When do I need ethical approval to conduct the Global-PPS?
3. How can I register my institution?

1. What do I need to prepare to conduct the Global-PPS?

To start conducting the Global-PPS, we recommend that you prepare the following things:

• Create a multidisciplinary team within your institution. Please choose one person who is the lead, or the focal person, for the survey. This person will become the local administrator, i.e. the person who oversees the project, and who registers the institution in the online data entry environment. It will become more feasible to do the PPS in a team that helps you collect and enter data.
• If necessary, obtain ethical approval from the relevant ethical committee of your institution. For more information, go to our question about ethical approval.
• Consult the relevant Global-PPS protocol:
  • the basic + optional healthcare-associated infections (HAI) inpatient protocol for (inpatient) hospitals (with optional interest in intervention-related healthcare-associated infections).
  • the outpatient protocol for (outpatient) healthcare facilities.
• Print the data collection forms:
  • 1 Department form for each department that you survey
  • 1 Patient form for each patient that you survey
  • 1 Short patient form for 4 outpatients without antimicrobial treatments

Note: in the outpatient module, it is also possible to directly enter your department and patient data within the Global-PPS tool. For the inpatient module, this is only advised if you have all the information readily available at the point of data entry.

• Inform and train your team! Inform your team and other staff present in the departments about the survey. Please train your team in advance on how to collect and record the data. You are very welcome to join one of our upcoming training webinars, or watch a recording of a previous webinar.

• [Optional] Conduct a pilot study. To facilitate smooth data collection, it is possible to conduct a pilot study: a small, initial study to train your staff and make them more familiar with the method.

2. When do I need ethical approval to conduct the Global-PPS?

The need for ethical approval depends entirely on the regulations in your setting. If you participate in the inpatient module, you will need to obtain approval from the relevant ethical committee if your country/setting requires it for retrospective audits. Since the Global-PPS is considered a retrospective audit, some countries may not require ethical approval.

If you participate in the outpatient module, it depends on how you collect your data:

• If you collect the data retrospectively, you will need to obtain approval from the relevant ethical committee if your country/setting requires it for retrospective audits. In some countries, you do not need ethical approval to conduct a retrospective audit.
• If you collect the data prospectively, it’s more likely that you need ethical approval before conducting the study.

However, an exempt can be obtained from the ethical committee in case the PPS is considered a quality improvement study.

3. How can I register my institution?

You can register for the Global-PPS in our . First, you will need to register yourself and confirm your registration by email. After you log in, you can register your institution. The person who registers the institution automatically becomes the local administrator, the focal person for the Global-PPS. Then, you can add additional users, create your departments, and collect data. After data entry, you can download your report.

1. How do I and my team familiarize ourselves with the Global-PPS methodology?
2. Where can I enter data?
3. Where can I find technical support for data entry?
4. What should I do if I encounter issues with the website?
5. What if I lost my login?
6. Can I add extra users to help with data entry?
7. What if the institution administrator needs to be changed?
8. What if I want to register data for a different institution?

1. How do I and my team familiarize ourselves with the Global-PPS methodology?

To learn more about the Global-PPS aims, methodology and different features, please join one of our upcoming training webinars, or watch a recording of a previous webinar.

2. Where can I enter data?

Data can be entered in our web application. Please find more detailed instructions in the user manuals in the application. You can only enter data after you have logged in to the application and registered your institution. Then you will need to select the survey period in which you collected data. Finally, you can proceed with data entry.

3. Where can I find technical support for data entry?

Our web application contains detailed instruction videos as well as a user manual. Still have any questions? Please contact us at global-pps@uantwerpen.be.

4. What should I do if I encounter issues with the website?

Does the website not work well? Please check if you’re using Google Chrome. If not, it could be that the browser you are using does not fully support our web application.

If you are using Chrome and have an internet connection, but still experience any issues, please contact us at global-pps@uantwerpen.be.

5. What if I lost my login?

If you lost your password, you can click ‘Forgot password’ in the login page. After filling in your username and email address, a new password will be sent to you by email. You can change this password within the application under ‘My profile’ and ‘Change password’.

6. Can I add extra users to help with data entry?

Yes, as an institutional administrator, you can add extra users. You can do this within our web application, by going to ‘User management’ and then adding extra users. Please find more detailed instructions in the user manuals in the application.

Please note that these extra users can also download the institution feedback report.

You can also remove access for former users.

7. What if the institution administrator needs to be changed?

If you want to change the institution administrator because, for example, the former administrator no longer works in your institution, you can contact global-pps@uantwerpen.be with this request. Please put the former institution administrator in CC so that they are aware of this change.

8. What if I want to register data for a different institution?

If the institution has not been registered in the Global-PPS tool yet, you can register it and enter data for this institution. If it already exists, please contact us at global-pps@uantwerpen.be and we will get in touch with the institution administrator of the originally created institution. This administrator can add you as an extra user.

1. What kind of results will I obtain after data entry? 
2. How can I access the feedback report after data entry?
3. How are the results of the Global-PPS used?
4. Can I compare my institution’s results with others?
5. How is the data from the Global-PPS analysed and reported?

1. What kind of results will I obtain after data entry?

After data entry, you can download your data in Excel and generate the feedback report after additional validation/finalization of your survey within our web application. Please find more detailed instructions in the user manuals in the application.

If you are the administrator of multiple institutions, you can also obtain a merged feedback report containing aggregated data from all your institutions.

If you are interested in longitudinal data, you can use the interactive reporting function: a tool within the web application that allows you to create your own graphs, selecting different filters as you like. Please note this function is not available for the outpatient module yet.

2. How can I access the feedback report after data entry?

You can generate the feedback report after validating/finalizing your survey within our web application. Please find more detailed instructions in the user manuals in the application. The feedback report will be automatically sent to your email address after you click the button to generate the report.

3. How are the results of the Global-PPS used?

The institution remains the owner of their database at all times and decides how the Global-PPS results are used. Please note that all validated data are used in the benchmarking results, aggregated with the results of all other institutions within that period. If less than three institutions participated in one period, the data will not appear in the benchmark.

The names of institutions are never disclosed in the benchmark and are not included in any manuscript or report without the institution’s explicit approval.

4. Can I compare my institution’s results with others?

Yes, you can use the benchmarking data to compare your own data with the data of other institutions in your country, continent, Europe (for non-European institutions), and with institutions of a similar hospital type in your continent.

We ask you not to use these benchmarking data in any publications (including all published manuscripts, reports, abstracts, etc.). If you wish to use these benchmarking data, please contact us at global-pps@uantwerpen.be. We will then reach out to each institution to request their consent for using their data as benchmarking data in a manuscript.

5. How is the data from the Global-PPS analysed and reported?

All analyses are descriptive analyses at patient- or prescription-level. Data from your institution is compared to country-, continent- and institution-type-level data.  More details on the results are presented in the feedback reports.

You can find an example of the inpatient feedback report under Documentos . You can find an example of the outpatient feedback report under Outpatient project.

1. How can I ensure that hospital staff feel comfortable and not evaluated during the survey?
2. What if the auditor perceives clinical malpractice or risk of a severe medical event for a surveyed patient?

1. How can I ensure that hospital staff feel comfortable and not evaluated during the survey?

We think it is very important to address this issue before conducting the survey. In our feedback reports, we never present data by individual prescriber, as our goal is not to assess specific prescribers, but to improve overall prescribing practices. It might be good to take a look at our protocol and/or feedback report together with your prescribers/healthcare staff so that your staff can see what the study entails and how the results are reported. Where possible, involve the ward staff as much as possible and discuss the PPS results with them.

Furthermore, it is important to note that the results of your institution are never shared. Only the local admin and Global-PPS users of your institution can download the feedback report.

2. What if the auditor perceives clinical malpractice or risk of a severe medical event for a surveyed patient?

If during data collection or data entry, the auditor perceives questionable or potentially harmful prescribing practices (e.g. highly incorrect dose, drug-drug interactions with other medications, not considered medication allergies), please inform the prescriber immediately to safeguard patient care. Please record the original (potentially harmful) prescription in the survey, even if the treatment was changed, since this would be the practice if the auditor had not informed the prescriber.