Clinicians' perceptions of the problem of antimicrobial resistance in health care facilities.
BACKGROUND
Many clinicians do not comply with guidelines regarding antimicrobial resistance (AR). In response, the Centers for Disease Control and Prevention developed a national Campaign to Prevent Antimicrobial Resistance in Healthcare Settings that presents 4 strategies and 12 evidence-based steps.


METHODS
To assess clinicians' perceptions of AR, barriers and facilitators to preventing AR, and how best to reach clinicians, a questionnaire and 4 focus groups were conducted after presentation of the Campaign at 4 Pittsburgh Regional Healthcare Initiative hospitals.


RESULTS
One hundred seventeen clinicians completed the questionnaire; 28 participated in the focus groups. Clinicians were significantly more likely to perceive that AR was a problem nationally than in their own institution (95% vs 77%; P<.001) or practice (95% vs 65%; P =.002), consistent with focus group results (93% nationally vs 46% institution or practice). The 3 Campaign steps with the most barriers to implementation were "Treat infection, not colonization" (35%), "Stop treatment when infection is cured or unlikely" (35%), and "Practice antimicrobial control" (33%). Clinicians in the focus groups cited the additional barriers of the health care culture, lack of knowledge, and the nursing shortage; facilitators included education, information technology, and consults. Computer programs, posters, and local data were suggested for reaching clinicians about AR.


CONCLUSIONS
Clinicians perceive AR to be a complex national problem but less relevant to their own institution or practice. Providing clinicians with information and steps for preventing AR, as in the Campaign, may affect their perceptions of the problem and motivate them to take actions to ensure patient safety.
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, US Department of Health and Human Services, Atlanta, Ga. 30333, USA.
Tara Bridget
TB
Giblin
Ronda L
RL
Sinkowitz-Cochran
Patricia L
PL
Harris
Sharon
S
Jacobs
Kathy
K
Liberatore
Marsha A
MA
Palfreyman
Edward I
EI
Harrison
Denise M
DM
Cardo
D001291:Attitude of Health Personnel; D004352:Drug Resistance, Microbial; D004363:Drug Utilization / Q000592:standards*; D004502:Education, Medical, Continuing; D017144:Focus Groups; D019983:Guideline Adherence; D006761:Hospitals; D006801:Humans; D017053:Infection Control / Q000592:standards*; D008505:Medical Staff, Hospital / Q000523:psychology*; D010414:Pennsylvania; D017410:Practice Guidelines as Topic; D011795:Surveys and Questionnaires