Self-reported knowledge attitude and practice of healthcare professionals in the management of infection and antimicrobial stewardship: a systematic review

医护人员自我报告的感染管理和抗菌药物管理知识、态度和实践:一项系统评价

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Abstract

OBJECTIVES: This review synthesizes studies on health and social care professionals' (HCPs) knowledge, attitudes and practices (KAP) related to infection management, prevention, antimicrobial use, stewardship and resistance, to inform future research and policy. METHOD: In January 2024, a comprehensive search was conducted in Medline, Embase, Web of Science and CINAHL to identify relevant studies on HCPs' KAP in infection management and antimicrobial resistance (AMR). After deduplication, initial screening was done using Rayyan, with 10% checked for accuracy. Two reviewers independently assessed full texts, and data extraction was verified by another reviewer. Quality assessment was conducted by one reviewer, with 20% of studies double-checked. Studies published from 2016 onwards, focusing on the UK and comparable settings, were included. A narrative synthesis was performed due to heterogeneity between studies. RESULTS: Of 10 990 records, 113 studies were included. KAP measures varied, complicating direct comparisons. Some studies assessed objective knowledge while most measured perceived knowledge, revealling discrepancies between the two. While most participants acknowledged the harms of inappropriate antimicrobial use, willingness to engage in antimicrobial stewardship (AMS) varied by profession. Practice behaviour assessment indicated varying hand-hygiene compliance and AMS implementation, along with significant concerns about inappropriate antibiotic prescribing. CONCLUSION: The review highlights significant gaps in HCPs' KAP regarding infection prevention and AMS, with variations across professions. This underscores the need for targeted interventions. Additionally, standardized KAP assessment measures are essential to enhance comparability across different contexts. These findings provide a foundation for future research and policy initiatives aimed at combating AMR.

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