Barriers of implementation of an antibiotic checklist.

Daalen, F.V. van (2014) Barriers of implementation of an antibiotic checklist. thesis, Medicine.

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Abstract

Background: The increasing antimicrobial resistance rate (AMR) is one of the most important health care problems at this moment. The AMR problem is also present in the Netherlands. To help control AMR, a better use of the current agents is necessary. Guideline-based quality indicators (QIs) have been developed that define and measure appropriate antibiotic use for the treatment of bacterial infections in the hospital. A checklist based on these QIs can be a useful tool to stimulate appropriate use. However, the success of a checklist is not self-explanatory, and an appropriate implementation strategy is necessary. Therefore we have identified barriers that hinder the application of the antibiotic checklist. Methods: We have developed a questionnaire based on literature to determine barriers concerning the checklist, concerning the professional and social factors and concerning the organisation. It included 23 potential barriers. The questionnaire was sent to specialists and residents in seven hospitals. At least 25% of the participants had to say a determinant was a barrier, to accept the specific determinant as a barrier. Results: Seven barriers were identified, namely: low expectation of improvement of own antibiotic use; low expectation of patient’s satisfaction for checklist use; low expectation of colleagues’ checklist use; the thought that supervisors’ expectation of checklist use and nurses’ expectation of checklist use is low; negative previous experiences with checklists, and financial disincentives. A comparing analysis showed that the feasibility of the checklist was significantly lower according to the surgeons than to the medical doctors. Conclusion: This study does not have found a barrier concerning the checklist itself, which implies that the participants in general support the concept of the antibiotic checklist. An effective implementation of the antibiotic checklist includes 1) a role model who motivates healthcare workers for checklist-use 2) education about the expected outcome of checklist use 3) adaption of the design of the checklist that will make it more feasible for surgical patients.

Item Type:	Thesis (Thesis)
Supervisor name:	Assen, Dr. S. van and internist-infectioloog UMCG
Supervisor name:	Geerlings, Dr. S.E. and internist-infectioloog AMC
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:50
Last Modified:	25 Jun 2020 10:50
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1110

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