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BackgroundThe World Health Organization (WHO) cautions against unnecessary prolongation of postoperative antibiotics to prevent surgical site infections (SSI), however this practice is still common in many countries. This study aims to describe drivers of prolonged postoperative antibiotic prescribing and clinicians’ perspectives on antibiotics resistance and stewardship in Ethiopia.MethodsWe conducted semi-structured interviews of 16 surgeons and nine surgical ward nurses at three academic referral hospitals in Addis Ababa. Audio recordings were transcribed verbatim and coded. Codes were inductively and iteratively derived between two researchers, tested for inter-rater reliability (IRR), and the codebook was consistently applied to all transcripts. Thematic analysis was performed to understand drivers of prolonged prophylactic antibiotic use in surgical patients.ResultsInterviews revealed factors contributing to postoperative prophylactic antibiotics overprescribing, including inadequate infection prevention and control (IPC) practices, wide variability in local prescribing practices, and distrust in the applicability of WHO guidelines. Antimicrobial resistance was also identified as a major concern by staff. Barriers to improving stewardship included a lack of multidisciplinary teamwork to inform prescribing decisions, while solutions included constructing appropriate context-specific guidelines and improving evidence-based practices through input from local stakeholders, including surgeons, clinical pharmacists, and nurses.ConclusionsStudy participants perceived that existing evidence and guidelines did not apply in their settings due to high rates of surgical site infections and gaps in perioperative IPC practices (e.g., availability of water for handwashing, sterility breaches). These gaps were a key contributor to prophylactic antibiotic overprescribing, reinforcing the need to strengthen upstream and perioperative surgical antisepsis processes. The findings of this study underscore the importance of engaging multidisciplinary teams in strengthening antimicrobial stewardship efforts, aligning processes to achieve compliance with best practices, and the need for rigorous, contextually appropriate studies from these settings to inform policy.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12913-024-11650-4.

Researchers and practitioners in Work and Organizational Psychology (WOP) have devoted decades to understanding and developing performance management systems in organizations.The term performance management (PM) refers to organizational interventions or activities aimed at improving individual, group, or organizational performance, for example, via goal setting, feedback, and reward systems.Many organizations, including global players like Deloitte, Accenture, or Adobe are turning away from formal performance management systems towards more informal processes such as instant performance feedback.Some argue that performance management has failed, because in many ways it has been reduced to prescribed steps within formal administrative systems.Research in WOP and management shows that PM systems can be effective if they rely on the participation of the different stakeholders in defining performance criteria as well as on regular feedback based on those criteria.In this Special Edition of InPractice we would like to shed some light on the practical application of both innovative and evidence-based PM systems and their effects on performance, health, and organizational success.We are more than happy to present authors from both Europe and the U.S. using approaches that are closely related and rooted in WOP research.In our focal article we are delighted to present a paper by Robert D. Pritchard and Natalie Wright on the 10 biggest problems in PM and how to avoid them in practice.Bob Pritchard has influenced research in motivation, productivity, and performance management over the last five decades.His worldwide research programme on the ProMES methodology is one of the most striking contributions of WOP in practice.We had the chance to talk to Bob Pritchard about the 10 issues they came up with: C: Bob, tell me more about the reason, why you and Natalie decided to write the article. B:The background is that the 10 problems we're addressing here are fairly obvious.But in my experience, they are commonly done badly in organizations.

Tutorials on the scientific Python ecosystem: a quick introduction to central tools and techniques. The different chapters each correspond to a 1 to 2 hours course with increasing level of expertise, from beginner to expert.