Facilitate behavior change among surgeons for infection prevention and stewardship - lessons learned from Asia

Sep 29, 2026

Uploaded by Jasmine

This commentary highlights pragmatic contributors that enable strategic and sustainable surgical IPC and antimicrobial stewardship (AMS) initiatives. It focuses on how complex, high-pressure surgical environments shape adoption of evidence-based practices through administrative systems and human behavior. Three recommendations guide change: institutional leadership support, a multidisciplinary programmatic implementation plan, and motivational-interview based communication strategies.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages4

Reading Time10 min

AccessFree to download

Abstract

Key recommendations

Leadership support

Programmatic plans

Antimicrobial Stewardship & Healthcare Epidemiology (2026), 6, e2, 1–4 doi:10.1017/ash.2025.10252 Commentary Facilitate behavior change among surgeons for infection prevention and stewardship: lessons learned from Asia Anucha Apisarnthanarak MD1 , Pataravit Rukskul MD2 and Linda M. Mundy MD, PhD3 1Division of Infectious Diseases, Thammasat University Hospital, Pratum Thani, Thailand, 2Division of Neurosurgery, Thammasat University Hospital, Pratum Thani, Thailand and 3Department of Medicine, Icahn School of Medicine at Mount Sinai/Elmhurst, NY, USA Abstract This commentary informs on key pragmatic contributors to strategic and sustainable surgical IPC and AMS initiatives. Three key recommendations to strengthen and sustain surgical IPC and initiatives are (1) institutional leadership support, (2) a programmatic multidisciplinary implementation plan, and (3) effective communication strategies using motivational interview. (Received 24 November 2025; accepted 26 November 2025) Commentary Surgical care environments are complex, high-pressure settings where work flow, technical precision, and time efficiencies contribute to patient outcomes.1 Successful surgical infection prevention and control (IPC) programs require implementation of evidence-based practices, up-to-date policies, multidisciplinary collaboration, and dedicated leadership.2 Factors categorized as administrative and human behavior influence the uptake, diffusion, and integration of perioperative IPC and antimicrobial stewardship (AMS) practices. This commentary informs on key pragmatic contributors to strategic and sustainable surgical IPC and AMS initiatives. Three key recommendations to strengthen and sustain surgical IPC and initiatives are (1) institutional leadership support, (2) a programmatic multidisciplinary implementation plan, and (3) effective communication strategies. Executive, surgical, and IPC leadership support There are many published guidance recommendations to support innovative IPC quality improvement and sustained practice initiatives that are relevant to perioperative care.3,4 Atthe institutional level, IPC teams generally conduct annual risk assessments to prioritize data-driven ranking of risks and hazards to focus on followed by gain of agreement and resources from the executive leadership team for the plan. For the selected surgical priorities such as risk minimization of medical errors, healthcare-associated infection (HAI), and appropriate medication management, joint institutional support from executive, surgical, IPC, and pharmacy leadership is foundational for the trust necessary to foster commitment, accountability, and results.3–5 At the top of the hierarchy of risk controls adopted from industry and occupational health, elimination, Corresponding author: Anucha Apisarnthanarak; Email: [anapisarn@yahoo.com](anapisarn@yahoo.com) [Cite this article:](Cite this article: Apisarnthanarak A)[ Apisarnthanarak A](Cite this article: Apisarnthanarak A), [Rukskul P](Rukskul P), [Mundy LM](Mundy LM). Facilitate behavior change among surgeons for infection prevention and stewardship: lessons learned from Asia. Antimicrob Steward Healthc Epidemiol 2026. doi: 10.1017/ash.2025.10252 substitution, and engineering controls are deemed more effective than administrative and human behavioral controls as they control exposures without significant human interaction.5,6 In surgical care areas, elimination, substitution, and engineering controls include but are not limited to single-use equipment, central sterile processing of reusable equipment, electrical control checks ofequipment, operating and procedural room standards for temperature, negative air pressure, and humidity, and ongoing substitution of newer, safer equipment when feasible. In contrast, administrative and human factor controls entail significant commitment to policy and practice compliance, work flow, effective communication, mutual purpose agreements, educati

FAQs

What are the three key recommendations proposed to strengthen surgical IPC and AMS initiatives?

The commentary recommends (1) institutional leadership support, (2) a programmatic multidisciplinary implementation plan, and (3) effective communication strategies using motivational interviewing.

Why does the commentary emphasize behavior change among surgeons in surgical IPC and AMS?

Surgical care environments are complex and high-pressure; administrative systems and human behavior affect how perioperative IPC and AMS practices are taken up, diffused, and integrated.

What is the suggested six-step approach for launching a surgical IPC initiative at Thammasat University Hospital?

It begins with assurance of joint administrative leadership endorsement, then establishes a multidisciplinary team with agreed roles, followed by identification and endorsement of a specific IPC or AMS intervention by the team.

Sep 29, 2026

Uploaded by Jasmine