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Notas de Investigação
Introduction
The global health capacity to sustainably tackle infec-
tious diseases is at risk, by the rising of antibiotic resis-
tance (AR) [1]. HAITooL (Healthcare-associated Infec-
tions Tool) is a surveillance and decision-support system
for effective antibiotic stewardship programs (ASP). Its
design, development and implementation, under a par-
ticipatory process, reveals benefits in organizational and
behavior change, despite some inherent barriers. At the
end, it leverages the healthcare professionals (HP) work.
Healthcare-associated Infections (HAI) are an impor-
tant cause of morbidity and mortality [2], worldwide.
HAI and Antibiotic Resistance (AR) impact populations,
weakening their health, socially and economically, with
human losses of thousands of people per year [2]. As a
global public health priority, it overloads the systems
with direct and indirect costs [3].
The general high consumption of antibiotics suggests that
one of the issue to address is at the doctor’s office, the
inappropriate prescription. It leads to the development
of multidrug resistance mechanisms. In general, we can
address the problem by tackling one or both antibiot-
ic-resistant HAI and AR dissemination and antibiotics
consumption reduction. Several strategies such as hand
hygiene, surveillance, decision-support information sys-
tems or ASP development are frequently indicated for a
prevention and control program [4].
The HAI andAR control essentially lies on human behav-
ior, for the patients’ health and safety. Human behavior is
a driver with significant association to control system’s
performance key-indicators [5]. Epidemiological differ-
ences throughout Europe indicate cultural condition-
ing factors of human behavior, such as perceptions and
values among the HP community [6]. Combining the
socio-cultural, political and organizational dimensions,
we can conduct a HAI andAR control program, through
behavior change at individual and organizational levels.
Organizational aspects in infection control, human and
other resources, professionals’ workload, education and
training, the need for multimodal and multidisciplinary
programs, individual and team motivation, engagement
and commitment to the programs, among others, are
key for a positive organizational culture [7].
Technological innovation solutions can leverage the HP
work and help address their organizational needs. The
prevention, management and control of HAI and AR
require readiness for response and action, with the im-
mediate and clear communication between all the ASP
key-actors. Computerized surveillance and decision sup-
port systems, with interactive and integrated data visu-
alization technology-based features can effectively help
address the issue, improving the HP performance and
work quality [8,9].
The main goal was to design and implement an informa-
tion system - HAITooL - which could effectively be a tool
for the HAI andAR surveillance, being as well a decision-
support system for antibiotics prescription. It aims at im-
Fig.1 -
HAITooL's Design Science Research Methodology framework.