IMproving Adherence to Guidelines in Infectious diseases through Nudging and Education (IMAGINE)
All hospitals strive for sound antibiotic and infection prevention policies, but in the Netherlands adherence to hand hygiene guidelines is only 20% and inappropriate prescribing of antibiotics is frequent with 30-70% guideline deviation. In hospitals, mainly junior doctors fulfil the role of ward-physician. They are responsible for the majority of antibiotic prescriptions and play an essential role in preventing healthcare associated infections through adequate hand hygiene. These responsibilities are to be met in a stressful period of transition from student to physician, during which they perceive a lack of knowledge and skills, specifically in prescribing medication. Education at commencement of work, aimed at practicing guideline-based medicine in busy daily practice could facilitate this transition. As sound preparation alone is insufficient to change behaviour and guideline adherence detiorates with experience, measures to support the effect of such education are essential. One such method, not yet commonly applied in health care, is nudging: a friendly push to encourage desired behaviour. Combining preparatoy education and behavioural nudges seems perfectly suited to improve antibiotic prescribing and infection prevention among junior doctors.