How do professional relationships influence surgical antibiotic prophylaxis decision making? A qualitative study.

摘要: Background Surgical antibiotic prophylaxis (SAP) is a critical area to optimize reduce the escalation of antimicrobial resistance. This article explores ways by which interpersonal relationships influence SAP decision making. Methods Twenty surgeons and anesthetists participated in in-depth semistructured interviews on prescribing. Results were analyzed using framework approach. Analysis revealed 3 SAP: relationship dynamics between surgeon anesthetist determine appropriateness SAP, particularly operative risk ownership; perceived hierarchies within, between, surgical specialties prescribing decisions; distance from stewardship team, influences use principles. Conclusions Interventions are more likely be effective enacting sustained change if they consider social contexts, including issues familiarity cohesiveness, hierarchical patterns, sense place within team. Significant relational making centered around risk; that is, personal/reputational different professional groups ownership for individual patient outcomes. Risk must therefore considered sustainable optimization interventions.