Cross-border comparison of antimicrobial resistance (AMR) and AMR prevention measures: the healthcare workers' perspective

J Keizer; L M A Braakman-Jansen; S Kampmeier; R Köck; N Al Naiemi; R Te Riet-Warning; N Beerlage-De Jong; K Becker; J E W C Van Gemert-Pijnen

doi:10.1186/s13756-019-0577-4

Cross-border comparison of antimicrobial resistance (AMR) and AMR prevention measures: the healthcare workers' perspective

Antimicrob Resist Infect Control. 2019 Jul 22:8:123. doi: 10.1186/s13756-019-0577-4. eCollection 2019.

Authors

J Keizer¹, L M A Braakman-Jansen¹, S Kampmeier², R Köck^{2

3

4}, N Al Naiemi^{5

6}, R Te Riet-Warning⁵, N Beerlage-De Jong¹, K Becker³, J E W C Van Gemert-Pijnen¹

Affiliations

¹ 1Department of Psychology, Health and Technology, Centre for eHealth and Wellbeing Research, University of Twente, P.O. Box 217, 7500AE Enschede, The Netherlands.
² 2Institute of Hygiene, University Hospital Münster, Münster, Germany.
³ 3Institute of Medical Microbiology, University Hospital Münster, Münster, Germany.
⁴ Institute of Hospital Hygiene Oldenburg, Oldenburg, Germany.
⁵ 5Department of Infection Prevention, Hospital Group Twente, Almelo/Hengelo, Netherlands.
⁶ LabMicTA, Hengelo, Netherlands.

Abstract

Background: Cross-border healthcare may promote the spread of multidrug-resistant microorganisms (MDRO) and is challenging due to heterogeneous antimicrobial resistance (AMR) prevention measures (APM). The aim of this article is to compare healthcare workers (HCW) from Germany (DE) and The Netherlands (NL) on how they perceive and experience AMR and APM, which is important for safe patient exchange and effective cross-border APM cooperation.

Methods: A survey was conducted amongst HCW (n = 574) in hospitals in DE (n = 305) and NL (n = 269), using an online self-administered survey between June 2017 and July 2018. Mann-Whitney U tests were used to analyse differences between answers of German and Dutch physicians (n = 177) and German and Dutch nurses (n = 397) on 5-point Likert Items and Scales.

Results: Similarities between DE and NL were a high awareness about the AMR problem and the perception that the possibility to cope with AMR is limited (30% respondents perceive their contribution to limit AMR as insufficient). Especially Dutch nurses scored significantly lower than German nurses on their contribution to limit AMR (means 2.6 vs. 3.1, p ≤ 0.001). German HCW were more optimistic about their potential role in coping with AMR (p ≤ 0.001), and scored higher on feeling sufficiently equipped to perform APM (p ≤ 0.003), although the mean scores did not differ much between German and Dutch respondents.

Conclusions: Although both German and Dutch HCW are aware of the AMR problem, they should be more empowered to contribute to limiting AMR through APM (i.e. screening diagnostics, infection diagnosis, treatment and infection control) in their daily working routines. The observed differences reflect differences in local, national and cross-border structures, and differences in needs of HCW, that need to be considered for safe patient exchange and effective cross-border APM.

Keywords: Antimicrobial resistance (AMR); Cross-border; Euroregion; Germany; Healthcare worker; Infection control; Multidrug-resistant microorganisms; Netherlands; Prevention.

Publication types

Comparative Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Antimicrobial Stewardship
Cross-Sectional Studies
Drug Resistance, Bacterial*
Female
Germany
Humans
Infection Control / methods*
Male
Middle Aged
Netherlands
Nurse's Role
Physician's Role
Practice Guidelines as Topic
Surveys and Questionnaires
Young Adult