Determinants of orthopedic physicians’ self-reported compliance with surgical site infection prevention: results of the WACH-trial’s pilot survey on COM-B factors in a German university hospital

Autor: Ivonne Tomsic, Ella Ebadi, Frank Gossé, Ina Hartlep, Pamela Schipper, Christian Krauth, Bettina Schock, Iris F. Chaberny, Thomas von Lengerke
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Antimicrobial Resistance and Infection Control, Vol 10, Iss 1, Pp 1-9 (2021)
Druh dokumentu: article
ISSN: 2047-2994
DOI: 10.1186/s13756-021-00932-9
Popis: Abstract Background Prevention of surgical site infections (SSIs), which due to their long-term consequences are especially critical in orthopedic surgery, entails compliance with over 20 individual measures. However, little is known about the psychosocial determinants of such compliance among orthopedic physicians, which impedes efforts to tailor implementation interventions to improve compliance. Thus, for this professional group, this pilot survey examined psychosocial determinants of self-reported compliance, which have been theoretically derived from the COM-B (Capability, Opportunity, Motivation and Behavior) model. Methods In 2019, a cross-sectional survey was conducted in a tertiary care university orthopedic clinic in Hannover, Germany, as a pilot for the WACH-trial (“Wundinfektionen und Antibiotikaverbrauch in der Chirurgie” [Wound Infections and Antibiotics Consumption in Surgery]). Fifty-two physicians participated (38 surgeons, 14 anesthesiologists; response rate: 73.2%). The questionnaire assessed self-reported compliance with 26 SSI preventive measures, and its psychosocial determinants (COM-B). Statistical analyses included descriptive, correlational, and linear multiple regression modeling. Results Self-reported compliance rates for individual measures varied from 53.8 to 100%, with overall compliance (defined for every participant as the mean of his or her self-reported rates for each individual measure) averaging at 88.9% (surgeons: 90%, anesthesiologists: 85.9%; p = 0.097). Of the components identified in factor analyses of the COM-B items, planning, i.e., self-formulated conditional plans to comply, was the least pronounced (mean = 4.3 on the 7-point Likert scale), while motivation was reported to be the strongest (mean = 6.3). Bi-variately, the overall compliance index co-varied with all four COM-B-components, i.e., capabilities (r = 0.512, p
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