[Compliance with infection control guidelines].

Abstract

Compliance is the degree to which advice is adhered to. It can be assumed that compliance rates are considerably less than 100% for nearly all infection control guidelines. Factors that may influence compliance rates can be found on different levels of the health care system. Health care workers may adhere to guidelines because they believe that a measure is effective, they receive positive or negative feedback, or because they follow role models. The institution is responsible for providing the structural conditions that allow easy adherence. Incentives for the institution are regulations that have been made mandatory by law or financial considerations. Finally, guidelines must be accepted by society to be widely adhered to. Compliance can be measured by direct or indirect surveillance. If it is found to be under the expected value, it should be improved using interventional programs. Long-lasting effects on compliance rates can be achieved by using a multifactorial approach that considers all levels of the health care system. The goal of the program should be clearly defined and accepted by all parties. Especially the institution should highly value the goal. Strategies that may be used to improve compliance include educational programs for health care workers, provision of better structures by the institution, e. g., administrative sanction or rewarding, or education of patients to influence the expectations of society. As long as there are no striking new interventions to protect the patients, the improvement of compliance with existing guidelines remains the most important measure to reduce rates of nosocomial infection.