Barriers and Facilitators in Perioperative Antibiotic Prophylaxis: A Mixed-Methods Study in a Small Island Setting

Few studies have addressed antibiotic guideline adherence in small island settings, such as Aruba. This study aimed to evaluate the appropriateness of perioperative antibiotic prophylaxis (PAP) and identify barriers for PAP guideline adherence. A mixed-methods study was carried out at the operating...

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Bibliographic Details
Published in:	Antibiotics (Basel) Vol. 10; no. 4; p. 462
Main Authors:	Mun, Liza A M van, Bosman, Sabien J E, Vocht, Jessica de, Kort, Jaclyn de, Schouten, Jeroen
Format:	Journal Article
Language:	English
Published:	Switzerland MDPI AG 19-04-2021 MDPI
Subjects:	Age antibiotic stewardship Antibiotics Antiinfectives and antibacterials Antimicrobial agents Disease prevention Drug resistance Evaluation Hospitals Interviews Mixed methods research Mortality Orthopedics Patients perioperative antibiotic prophylaxis Professionals Prophylaxis Regression analysis small island setting Surgeons Surgery Surgical outcomes Netherlands Aruba perioperative antibiotic prophylaxis antibiotic stewardship small island setting
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Summary:	Few studies have addressed antibiotic guideline adherence in small island settings, such as Aruba. This study aimed to evaluate the appropriateness of perioperative antibiotic prophylaxis (PAP) and identify barriers for PAP guideline adherence. A mixed-methods study was carried out at the operating theatre (OT) in the Dr. Horacio E. Oduber Hospital (HOH) in Aruba. First, a prospective audit was performed on the appropriateness of guideline-derived quality indicators (QIs). Then, interviews based on the Flottorp framework were conducted to identify barriers for guideline adherence. Finally, a survey was distributed to verify the outcomes of the interviews. The appropriateness of QIs was measured: correct indication (50.6%); antimicrobial agent (30.8%); dose (94.4%); timing (55.0%); route of administration (100%); duration (89.5%); and redosing (95.7%). The overall appropriateness was 34.9%. The main barriers discovered were poor knowledge about PAP and the guidelines and professional interactions regarding PAP, specifically poor communication and lack of clarity about responsibilities regarding PAP. This study was the first to evaluate the appropriateness and to identify barriers for PAP guideline adherence in a small island hospital. The overall appropriateness of PAP was poor with just 34.9%. Future interventions should be focused on communication, education and awareness of the possibility to consult an ID physician or microbiologist.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 These authors contributed equally to this work.
ISSN:	2079-6382 2079-6382
DOI:	10.3390/antibiotics10040462