title: A survey to identify barriers of implementing an antibiotic checklist.
abstract: A checklist is an effective implementation tool, but addressing barriers that might impact on the effectiveness of its use is crucial. In this paper, we explore barriers to the uptake of an antibiotic checklist that aims to improve antibiotic use in daily hospital care. We performed an online questionnaire survey among medical specialists and residents with various professional backgrounds from nine Dutch hospitals. The questionnaire consisted of 23 statements on anticipated barriers hindering the uptake of the checklist. Furthermore, it gave the possibility to add comments. We included 219 completed questionnaires (122 medical specialists and 97 residents) in our descriptive analysis. The top six anticipated barriers included: (1) lack of expectation of improvement of antibiotic use, (2) lack of expected patients' satisfaction by checklist use, (3) lack of feasibility of the checklist, (4) negative previous experiences with other checklists, (5) the complexity of the antibiotic checklist and (6) lack of nurses' expectation of checklist use. Remarkably, 553 comments were made, mostly (436) about the content of the checklist. These insights can be used to improve the specific content of the checklist and to develop an implementation strategy that addresses the identified barriers.
authors.affiliation: Department of Internal Medicine, Division of Infectious Diseases, Centre for Infection and Immunity Amsterdam, Academic Medical Centre, Room F4-106, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. f.v.vandaalen@amc.nl.
authors.forename: F V
authors.initials: FV
authors.lastname: van Daalen
authors.affiliation: Department of Internal Medicine, Division of Infectious Diseases, Centre for Infection and Immunity Amsterdam, Academic Medical Centre, Room F4-106, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: S E
authors.initials: SE
authors.lastname: Geerlings
authors.affiliation: Department of Internal Medicine, Division of Infectious Diseases, Centre for Infection and Immunity Amsterdam, Academic Medical Centre, Room F4-106, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: Prins
authors.affiliation: Scientific Institute for Quality of Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: M E J L
authors.initials: ME
authors.lastname: Hulscher
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D057189:Checklist / Q000706:statistics & numerical data*; D004358:Drug Therapy / Q000592:standards*; D006761:Hospitals; D006801:Humans; D009426:Netherlands; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents
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