Table 2 Needs for future APM-AF
Code | Sub-code | Variation | n | Quote |
|---|---|---|---|---|
Needs audit | Content | Insights in diagnostics | 6 | “Do we use the right diagnostics for our patients? In other words, do we test too much or do we take the wrong tests?” P(17.36) |
Insights in empirical and targeted treatment | 4 | “I would like to know for a certain clinical presentation how we start our treatment, which antibiotics we start with.” P(13.29) | ||
Insights in infection control measures | 4 | “For infection control I would like to know what percentage gets clean clothes every day. And what effect that would have on the prevention of new infections. I would also like to know if hand hygiene is adequately applied and if people comply to the dress code. Also, the use of non-sterile or sterile gloves.” R(04.16) | ||
Insights in infection outcomes | 3 | “I would like to see how we perform in the hospital; how often do we have resistant micro-organisms and how often are these transmitted to other patients or personnel.” R(05.21) | ||
Insights in resistance patterns | 5 | “Insights in diagnostic results, resistance patterns, not for individual patients, but overall. How the resistance patterns have developed over time.” P(02.16) | ||
Norms | Benchmark | 8 | “If I would be compared to colleagues for example, that might be scary, but eventually you can learn a lot from it.” R(04.31) | |
Trends over time | 4 | “You could do a baseline measurement, so how are we performing now. And then look how it evolves over time when you change things.” P(17.50) | ||
Needs feedback | Content | Simple and concrete points of improvement and recommendations | 7 | “Some points we might be able to change ourselves, such as poor hygiene or so. But it may also be that policies need to be adapted, that certain antibiotics may or may not be given anymore. You really have to give something back that it is not just plain facts.” N(09.56) |
Feedback tailored to target group | 8 | “I would indeed stick to one group [nurses or physicians] and focus on that specific target group. Adapt the feedback to that group.” N(15.23) | ||
Substantiated recommendations | 11 | “I want to be convinced with good arguments. I understand that there are rules and you must adhere to them, so I adhere to them. But I find it very annoying when people can’t explain why. It seems logical and it is tangible, but if it is not scientifically proven, then I think you should thoroughly study it before you set a rule.” P(08.33) | ||
Form | Mail/ newsletter /poster | 4 | “I would like to receive some kind of newsletter online”. P(05.31) | |
Interactive | 13 | “Just data is an empty shell. You have to present it, you have to discuss it, you have to work with it.” R(04.40) | ||
Frequency | Not too often, but recurrent | 14 | “Oh, not every week or month, then it is way too much. I think every six months, something like that. Because otherwise it will only overwhelm you and then it seems to be a goal and not a means for something.” P(17.62) | |
AF implementation | Approach | Positive | 4 | “I think positive reinforcement is better than focusing on the negative.” P(14.40) |
Transparent | 1 | “If there are consequences from AF, you have to explain in advance clearly why it happens with what purpose, that it is linked to a standard and that there is time to improve.” P(17.62) | ||
Ownership | Bottom-up | 9 | “It is also easier to hear feedback from someone you see more often than from someone who just shows up and has something to say about your work.” N(15.43) | |
AMR/infection experts | 8 | “By someone who is knowledgeable about these topics.” N(09.49) | ||
Interdisciplinary | 6 | “It would be very valuable to have regularly multidisciplinary meeting with the bacteriologists and possibly infectiologists or an infection committee.” P(02.24) | ||
Supported by supervisors and management | 3 | “It must be supported by the organization, so people at the top, the management.” R(10.44) |