Exploring barriers to guideline implementation for prescription of surgical antibiotic prophylaxis in Nigeria
Year: 2022
Type: article
Study design: Observational Study
Abstract: Background In Nigeria, the prescription of surgical antibiotic prophylaxis for prevention of surgical site infection tends to be driven by local policy rather than by published guidelines (e.g. WHO and Sanford). Objectives To triangulate three datasets and understand key barriers to implementation using a behavioural science framework. Methods Surgeons (N = 94) from three teaching hospitals in Nigeria participated in an online survey and in focus group discussions about barriers to implementation. The theoretical domains framework (TDF) was used to structure question items and interview schedules. A subgroup (N = 20) piloted a gamified decision support app over the course of 6 months and reported barriers at the point of care. Results Knowledge of guidelines and intention to implement them in practice was high. Key barriers to implementation were related to environmental context and resources and concern over potential consequences of implementing recommendations within the Nigerian context applicable for similar settings in low-to-middle-income countries. Conclusions The environmental context and limited resource setting of Nigerian hospitals currently presents a significant barrier to implementation of WHO and Sanford guidelines. Research and data collected from the local context must directly inform the writing of future international guidelines to increase rates of implementation.
Source: JAC-Antimicrobial Resistance
Authors: Caroline E. Wood, Susanne Luedtke, Anwar Musah, Funmi Bammeke, Bamidele Mutiu, Rufus Ojewola, Olufemi Bankole, Adesoji Oludotun Ademuyiwa, Chibuzo Barbara Ekumankama, Folasade Ogunsola, Patrick Okonji, Eneyi E. Kpokiri, Theophilus Ayibanoah, Neni Aworabhi-Oki, Laura Shallcross, Andreea Molnar, Sue Wiseman, Andrew Hayward, Delphine Soriano, Georgiana Birjovanu, Carmen Lefevre, Olajumoke Olufemi, Patty Kostkova
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,219
OpenAlex ID: W4224309216