Improvisation versus guideline concordance in surgical antibiotic prophylaxis: a qualitative study.
Purpose: Surgical antibiotic prophylaxis (SAP) is a common area of antimicrobial misuse. The aim of this study was to explore the social dynamics that influence the use of SAP.Methods: 20 surgeons and anaesthetists from a tertiary referral hospital in Australia participated in semi-structured interv...
| Publicado en: | Infection Vol. 46; no. 4; pp. 541 - 549 |
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| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Aug2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=131051364&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 131051364 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03008126 NXO jtl: Infection issn: 03008126 maglogo: N pubinfo: dt: Aug2018 vid: 46 iid: 4 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 131051364 131051364 131051364 10.1007/s15010-018-1156-y 131051364 ppf: 541 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Improvisation versus guideline concordance in surgical antibiotic prophylaxis: a qualitative study. aug: au: Broom, Jennifer Broom, Alex Kirby, Emma Post, Jeffrey J. affil: Sunshine Coast University Hospital, The University of Queensland, 6 Doherty Street, 4575, Birtinya, QLD, Australia sug: subj: Guideline Adherence Antibiotic Prophylaxis Preoperative Care Inappropriate Prescribing Human Physician Attitudes Surgeons Anesthetists Thematic Analysis Descriptive Statistics Data Analysis Software Australia Semi-Structured Interview ab: Purpose: Surgical antibiotic prophylaxis (SAP) is a common area of antimicrobial misuse. The aim of this study was to explore the social dynamics that influence the use of SAP.Methods: 20 surgeons and anaesthetists from a tertiary referral hospital in Australia participated in semi-structured interviews focusing on experiences and perspectives on SAP prescribing. Interview data were analysed using the framework approach.Results: Systematic analysis of the participants’ account of the social factors influencing SAP revealed four themes. First, antibiotic prophylaxis is treated as a low priority with the competing demands of the operating theatre environment. Second, whilst guidelines have increased in prominence in recent years, there exists a lack of confidence in their ability to protect the surgeon from responsibility for infectious complications (thus driving SAP over-prescribing). Third, non-concordance prolonged duration of SAP is perceived to be driven by benevolence for the individual patient. Finally, improvisation with novel SAP strategies is reported as ubiquitous, and acknowledged to confer a sense of reassurance to the surgeon despite potential non-concordance with guidelines or clinical efficacy.Conclusions: Surgical-specific concerns have thus far not been meaningfully integrated into antimicrobial stewardship (AMS) programmes, including important dynamics of confidence, trust and mitigating fear of adverse infective events. Surgeons require specific forms of AMS support to enact optimisation, including support for strong collaborative ownership of the surgical risk of infection, and intra-specialty (within surgical specialties) and inter-specialty (between surgery, anaesthetics and infectious diseases) intervention strategies to establish endorsement of and address barriers to guideline implementation. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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