Abstract：
Background:A Surgical Unit-based Safety Programme (SUSP) has been shown to improve perioperative prevention practices and to reduce surgical site infections (SSI). It is critical to understand the factors influencing the successful implementation of the SUSP approach in low- and middle-income settings. We undertook a qualitative study to assess viability, and understand facilitators and barriers to implementing the SUSP approach in 5 African hospitals. Methods:Qualitative study based on interviews with individuals from all hospitals participating in a WHO-coordinated before-after SUSP study. The SUSP intervention consisted of a multimodal strategy including multiple SSI prevention measures combined with an adaptive approach aimed at improving teamwork and safety culture. Results:Thirteen interviews (5 head surgeons, 3 surgeons, 5 nurses) were conducted with staff from five hospital sites. Identified facilitators included influential individuals (intrinsic motivation of local SUSP teams, boundary spanners, multidisciplinary engagement, active leadership support), peer-to-peer learning (hospital networking and positive deviance, benchmarking), implementation fitness (enabling infrastructures, momentum from previous projects), and timely feedback of infection rates and process indicators. Barriers (organisational 'constipators', workload, mistrust, turnover) and local solutions to these were also identified. Conclusions:Participating hospitals benefitted from the SUSP programme structures (e.g. surveillance, hospital networks, formation of multidisciplinary teams) and adaptive tools (e.g. learning from defects, executive rounds guide) to change perceptions around patient safety and improve behaviours to prevent SSI. The combination of technical and adaptive elements represents a promising approach to facilitate the introduction of evidence-based best practices and to improve safety culture through local team engagement in resource-limited settings.
journal_name
Antimicrob Resist Infect Controljournal_title
Antimicrobial resistance and infection controlauthors
Clack L,Willi U,Berenholtz S,Aiken AM,Allegranzi B,Sax Hdoi
10.1186/s13756-019-0541-3subject
Has Abstractpub_date
2019-05-30 00:00:00pages
91issn
2047-2994pii
541journal_volume
8pub_type
杂志文章,多中心研究abstract：BACKGROUND:Mcr-1-harboring Enterobacteriaceae are reported worldwide since their first discovery in 2015. However, a limited number of studies are available that compared full-length plasmid sequences of human and animal origins. METHODS:In this study, mcr-1-bearing plasmids from seven Escherichia coli isolates recove...
journal_title：Antimicrobial resistance and infection control
pub_type： 杂志文章
doi：10.1186/s13756-017-0250-8
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journal_title：Antimicrobial resistance and infection control
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journal_title：Antimicrobial resistance and infection control
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journal_title：Antimicrobial resistance and infection control
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journal_title：Antimicrobial resistance and infection control
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journal_title：Antimicrobial resistance and infection control
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journal_title：Antimicrobial resistance and infection control
pub_type： 杂志文章
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journal_title：Antimicrobial resistance and infection control
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journal_title：Antimicrobial resistance and infection control
pub_type： 杂志文章
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journal_title：Antimicrobial resistance and infection control
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journal_title：Antimicrobial resistance and infection control
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doi：10.1186/s13756-017-0249-1
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journal_title：Antimicrobial resistance and infection control
pub_type： 杂志文章
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journal_title：Antimicrobial resistance and infection control
pub_type： 杂志文章
doi：10.1186/s13756-019-0620-5
更新日期：2019-10-22 00:00:00
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journal_title：Antimicrobial resistance and infection control
pub_type： 杂志文章
doi：10.1186/s13756-020-00708-7
更新日期：2020-03-16 00:00:00
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journal_title：Antimicrobial resistance and infection control
pub_type： 杂志文章
doi：10.1186/s13756-017-0245-5
更新日期：2017-08-29 00:00:00
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journal_title：Antimicrobial resistance and infection control
pub_type： 杂志文章
doi：10.1186/s13756-020-00853-z
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journal_title：Antimicrobial resistance and infection control
pub_type： 杂志文章
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journal_title：Antimicrobial resistance and infection control
pub_type： 杂志文章
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journal_title：Antimicrobial resistance and infection control
pub_type： 杂志文章
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journal_title：Antimicrobial resistance and infection control
pub_type： 杂志文章
doi：10.1186/s13756-015-0071-6
更新日期：2015-07-25 00:00:00
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journal_title：Antimicrobial resistance and infection control
pub_type： 杂志文章
doi：10.1186/s13756-020-00794-7
更新日期：2020-08-05 00:00:00
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journal_title：Antimicrobial resistance and infection control
pub_type： 杂志文章
doi：10.1186/s13756-015-0081-4
更新日期：2015-10-14 00:00:00
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journal_title：Antimicrobial resistance and infection control
pub_type： 杂志文章,多中心研究
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更新日期：2019-07-16 00:00:00
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journal_title：Antimicrobial resistance and infection control
pub_type： 杂志文章
doi：10.1186/s13756-018-0299-z
更新日期：2018-01-26 00:00:00
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journal_title：Antimicrobial resistance and infection control
pub_type： 杂志文章
doi：10.1186/s13756-018-0312-6
更新日期：2018-02-13 00:00:00
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journal_title：Antimicrobial resistance and infection control
pub_type： 杂志文章
doi：10.1186/s13756-019-0568-5
更新日期：2019-07-11 00:00:00
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journal_title：Antimicrobial resistance and infection control
pub_type： 杂志文章
doi：10.1186/s13756-020-00792-9
更新日期：2020-08-17 00:00:00
abstract：BACKGROUND:Harmonization in hand hygiene training for infection prevention and control (IPC) professionals is lacking. We describe a standardized approach to training, using a "Train-the-Trainers" (TTT) concept for IPC professionals and assess its impact on hand hygiene knowledge in six countries. METHODS:We developed...
journal_title：Antimicrobial resistance and infection control
pub_type： 杂志文章
doi：10.1186/s13756-019-0666-4
更新日期：2019-12-30 00:00:00
