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Interventions to prevent the development of surgical site infections in Germany and the Netherlands : a systematic review

Köning, J.M. (2017) Interventions to prevent the development of surgical site infections in Germany and the Netherlands : a systematic review.

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Abstract:Introduction: Surgical site infections (SSIs) are wound infections which occur after surgery and result in pain for the patients, economic consequences in the form of higher costs, and an increase in antibiotic resistance. Recent statistics show that the number of SSIs has increased in the last years. There are current projects which have the goal of building a prevention network with interventions and technologies in the EUREGIO (Germany and the Netherlands). The goal of this study is to compare the German and Dutch SSI guidelines and to identify interventions which already exist that prevent SSIs. Five factors are important in the prevention of the development of SSIs: general hygiene, hand hygiene, hair removal, antibiotic prophylaxis, and normothermia. Due to the assumption that hand hygiene is the most important preventative factor, this research focuses only on interventions which influence this particular factor. Methods: To compare the German and Dutch guidelines, an unsystematic narrative review was conducted. The German and Dutch guidelines can be compared on the following points: form of representation, evidence, rule orientation, style, and content. The interventions which already exist to decrease the numbers of SSIs are identified with a systematic review. These can be compared based on target group, focus, phase (pre-operative, peri-operative, post-operative), the component of the Theory of Planned Behavior (TPB) which is used, modality, features, implementation, function mechanism, main effects, and conclusions. Results: There are small differences between the German and the Dutch guidelines concerning their content. More significant, however, are the differences between the guidelines regarding their outward appearance. Perceived behavior control is the component of the TPB which is used mainly during hand hygiene interventions to influence compliance with hand hygiene standards. Combining perceived behavior control with the components of attitude or subjective norms of the TPB offers the most successful results. Feedback is an important aspect of the improvement of hand hygiene compliance. The interventions identified through the systematic review are mostly very recent. Discussion: The differences between the German and Dutch guidelines possibly emerge because of stricter legislation in Germany. There are a number of studies which show that the factor perceived behavior control is the most important during hand hygiene in hospitals and that feedback has a positive influence on hand hygiene performance.
Item Type:Essay (Bachelor)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:77 psychology
Programme:Psychology BSc (56604)
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