Job Description

Medical Doctor Antimicrobial Stewardship Focal Point

Médecins Sans Frontières (MSF) is an international, independent, medical humanitarian organization that delivers emergency aid to people affected by armed conflict, epidemics, natural disasters and exclusion from healthcare. MSF offers assistance to people based on need, irrespective of race, religion, gender or political affiliation.

“Female candidates and people with disabilities are highly encouraged to apply “

MSF does not charge fees or accept any money during the entire recruitment process.”

MSF is advertising for the following position: Medical Doctor Antimicrobial Stewardship Focal Point

Requirements for the position

Education:    

• Essential: Medical Doctor Degree .
• Essential: Valid work permit – from medical council – Sanaa. As General Practitioner
• Desirable: completed (on-line) training in Antimicrobial stewardship [e.g. BSAC (British Society of Antimicrobial Chemotherapy) and/or WHO (World Health Organisation)]
• Desirable diploma in Tropical Medicine

Experience:    

• Essential: at least 5 years’ experience in working as a medical doctor in inpatient set-tings
• Desirable experience related to microbiology, laboratory medicine, infection/prevention/control and/or internal medicine.
• Desirable in tropical medicine, or post-registration experience in Public Health , obs and gynae, paediatrics, A&E, infectious diseases, TB, general practice, general medicine or minor surgery.
• Desirable: experience in reviewing medical records/reviewing appropriateness of anti-microbials

Languages:    

• Arabic and English are essential, especially the ability to produce reports in English

Knowledge    

• Computer literacy – word and excel. How to use data for feedback and reporting.

Competences:    

• People management • Commitment • Flexibility • Results • Analytical thinking • Planning and organisation • Teamwork

Description

• Place of work:    Abs District, Hajja Governorate, Republic of Yemen
• Level:    10
• Duration:    1-year fixed term contract with the possibility of extension. Subjected to a probationary period.
• Others:    Salary: Based on the organization scale

Main objectives:    

Lead an antimicrobial stewardship (AMS) program in a medical or surgical humanitarian hospital. Médecins Sans Frontières (MSF) / Doctors Without Borders has increased its focus on the problem of antibiotic resistance. Antimicrobial resistance (AMR) is growing rapidly in low and middle-income countries and MSF faces ongoing challenges managing antibiotic resistant infections in hospitalized patients particularly in patients with burns, trauma, hospital infections and in pediatric and neonatal care. AMR threatens patient outcomes, makes hospitals less safe and increases costs. MSF is committed to responding and one part of this response is to increase efforts to conserve the effectiveness of antibiotics through antibiotic stewardship

Main responsibilities and    tasks: ( standard )    

Medical Doctors tasks:

• Apply medical knowledge and skills to diagnose and prevention. Carry out outpatient and inpatient con- sultations, prescribing the necessary treatment respecting MSF protocols.
• Keep the patient and/or his/her family informed about the illness and provide appropriate explanations about the treatment to follow, checking they have understood.
• Follow up the evolution of the hospitalized/IDP patients, through daily visits , consultations and exami- nations, prescribing the necessary treatment following MSF protocols, deciding whether they can be discharged or transferred to other departments – in collaboration with other doctors- and informing their family about the patient’s evolution.
• Check and control the rational distribution of medicines and equipment under his/her responsibility and take care the quality, disinfection and sterilization of the medical material. Assure general compliance with standing hygiene standards.
• Participate in the collection and analysis of epidemiological data, checking its validity and informing the line manager or project coordinator about any problem or complication of the patients illness, medical error and monitors the proper functioning of the department, equipment or material.
• Ensure ongoing training of the medical/paramedical multidisciplinary team in order to optimize the quali- ty of care.
• Knows and ensures all MSF medical protocols are followed and implemented, checking universal pre- cautions are followed at all times and reducing bio-hazard risks and improving infection control. Ensures professional confidentiality is respected.
• Manage the team under his/her direct responsibility according to MSF HR policies and procedures, su- pervising their performance, organizing and scheduling shifts and rotations, directly participating in emergencies and on calls if necessary.

In addition, for Antimicrobial Stewardship Focal Point, the following apply ( standard ) :

• Leading, promoting and supporting antimicrobial stewardship efforts in the healthcare facility(s) across the spectrum of healthcare.
• Establish and participate in a multidisciplinary AS committee (that meets regularly with Terms of Reference).
• Identify antimicrobial stewardship priorities together with the AS committee and the mission.
• Monitor, collect and analyze the antimicrobial data reported to the multidisciplinary AS committee.
• Conduct regular audits relevant to stewardship priorities. This might include audits of antibiotic use, treatment of select conditions, indications for microbiology testing, and communication of results.
• Provide feedback to the project and the mission regarding results of audits and plan improvements.
• Co-ordinate and deliver education to other medical, nursing and pharmacy staff around stewardship.
• Support other clinical staff regarding antibiotic choices and regularly participate in clinical rounds.
• Liaise with the laboratory for timely communication of results (where relevant), interpretation of results and feedback to clinicians.
• Collaborate with lab + IPC to prospectively monitor pathogens of concern and respond to hospital outbreaks including outbreaks of multidrug resistant organisms/bacteria page 1 of 3 (MDRO).
• Identify opportunities to improve stewardship in the project (e.g., therapeutic drug monitoring, OPAT).
• Participate in relevant project level committees (e.g., IPC, Quality improvement, Morbidity + Mortality reviews).
• In collaboration with IPC and the clinical team, participate in detection, management and prevention of healthcare associated infections

MSF Section/
Context Specific Accountabilities    

Antibiotic stewardship focal points tasks and responsabilties – contextual
1.    Leading, promoting and supporting antimicrobial stewardship efforts in the hospital across the services considered key for an improved antimicrobial use (pediatrics, neonatology, ITFC, maternity, ER) through a different set of activities coordinated with other quality improvement efforts at project level.
2.    Establish and participate in a multidisciplinary AS committee and participate in other relevant committess as needed (IPC if separated, Quality Improvement, mortality & morbidity if they exists). Ensure regular meetings are carried out with the AMR referent, while collaborating with the AMR counterparts in the Yemen mission (Al Qanawis) as needed.
3.    Identify antimicrobial stewardship priorities together with the AS committee, defining and monitoring the implementation of an antimicrobial stewardship action plan together with HCL and Senior Medical Doctor (SMD).
4.    Monitor, collect and analyze together with Lab Supervisor, IPC supervisor, HCL and SMD, the antimicrobial data reported to the multidisciplinary AS committee, which includes theinputting of data into the WHONET database.
5.    Conduct regular audits relevant to stewardship priorities. This include regular Point Prevalence Surveys on antibiotic use (at least every 6 months), qualitative audits of antibiotic use, treatment of select conditions, indications for microbiology testing, and communication of results.
6.    Support pharmacy team and HCL/PMR in performing quantitative evaluations of antibiotic consumption, to put them in common in AMS committee.
7.    Provide feedback to the project regarding results of audits and plan improvements
8.    Produce a monthly or quarterly AMR report including key information of other stakeholders in AMS committee: hospital adquired infections surveillance, MDROs outbreaks situation, WHONET blood cultures data, summary of different activities conducted to monitore and improve antimicrobial use in the reporting period.
9.    Co-ordinate and deliver education to other medical, nursing and pharmacy staff around stewardship, infectious diseases, and antibiotic use (i.e: leading clinical case discussions or providing sessions around the different antibiobic families)
10.    Support other clinical staff regarding antibiotic choices and regularly participate in clinical rounds.
11.    Liaise timely with the laboratory and other clinicians for interpretation of blood cultures and antibiotic susceptibility testing results and feedback to clinicians.
12.    In collaboration with IPC and the clinical team, participate in detection, management and prevention of healthcare associated infections including case management and response to possible outbreaks of multidrug resistant organisms.
13.    In collaboration with HCL and pediatricians, monitor and control the usage of blood cultures and restricted antibiotics, and ensure organisation of the referral system for samples in collaboration with the HCL/PMR and RFP.
14.    In collaboration with the epidemiologist, HCL and PMR, play an active role in any evaluations linked to bacteriological analysis in the project.

Medical Doctor tasks and responsabilities:

Due to operational needs, the position may be requested to cover medical doctor shifts occasionally as requested by the supervisor, considering the following:
Provide safe, effective and respectful health care in Abs Hospital according to MSF protocols and Guidelines for the following departments:

• -Emergency Room: resposable of critical cases -red room-, follow up -yellow room- and consultations, as well as decide admission or discharge after proper assessment.
• -IPD Pediatrics: assesment, follow up, discharge criteria according with Pediatrics Guidelines.
• -ITFC: assesment, follow up, discharge criteria according to Nutritional Guidelines.
• -IPD Neonates: assesment, follow up, discharge criteria according NN guidelines, discussing the cases with pediatricians (IMS and/or NS).
• -Maternity: Supporting emergency cases in maternity (eclampsia, preclampsia, shock -for the mothers- and assessment of New born if is needed).
• -IPD Surgical: assessment of surgical cases if is needed.
• -IPD Isolation: assesment, follow up, discharge criteria.
• -OT: supporting emergencies when is needed.
• Participate in data collection following the roster of Medical Doctors.
• Mass Casualty Plan: Knowledge of mass casualty plan for Abs Hospital and the function to develop according to each position.
• Team work and flexibility: Support the rest of the medical team in different departments whenever is needed for Pediatrics, ITFC, Neonates, ER, Isolation, Maternity, Surgical and OT.