The use of tetanus post-exposure prophylaxis guidelines by general practitioners and emergency departments in the Netherlands: a cross-sectional questionnaire study

BMC Family Practice

Research Article

Susan Hahné¹  Margreet te Wierik¹  Robine Donken¹  Hester de Melker¹  Nicoline van der Maas¹  Corien Swaan¹  Tjerk Wiersma² 

[1] Centre for Infectious Disease Control, National Institute for Public Health and the Environment, P.O. Box 1 (postbak 75), 3720, Bilthoven, BA, The Netherlands;Dutch College of General Practitioners, Utrecht, The Netherlands;

关键词: Tetanus;    Post-exposure prophylaxis;    Guidelines;    Health council;    General practitioners;    Emergency departments;   

DOI  :  10.1186/1471-2296-15-112

 received in 2014-01-06, accepted in 2014-06-03,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundThe Dutch National Immunisation Programme includes six tetanus toxoid (TT) vaccinations and reaches a high rate of vaccination coverage. In the Netherlands, several guidelines related to tetanus post-exposure prophylaxis (T-PEP) are in place. In 2003, the Dutch Health Council (HC) reviewed the use of T-PEP. The aim of this study is to evaluate whether the HC recommendations have been implemented.MethodsWe asked 178 Dutch General Practitioner (GP) offices and 60 Emergency Departments (EDs) to participate in a cross-sectional questionnaire study and requested that participating facilities send in the T-PEP guidelines adopted by their practice. The differences, based on categories mentioned in the HC recommendations, between GPs and EDs and the type of T-PEP guidelines adopted were assessed.ResultsThe response rates for the GPs and EDs were 38% (n = 67) and 70% (n = 42), respectively. 98% percent (n = 107) of the participants reported having T-PEP guidelines. Of the guidelines described in the survey responses, 28% (n = 23; EDs 41%, GPs 21%) were consistent with the HC-recommendations, 36% (n = 29; EDs 7%, GPs 52%) adhered to the guidelines of the College of GPs (CGP), which restricts the use of T-PEP to tetanus prone wounds but for these wounds is in line with the recommendations of the HC. The remaining 36% had adopted other guidelines, most of which can lead to over-prescription of T-PEP. Information on T-PEP was lacking in patients with higher risk vaccination histories.ConclusionAlmost all participants have adopted T-PEP guidelines. Strict adherence to the HC recommendations is low. More than half of GPs have adopted the more restrictive CGP-guideline, which limits T-PEP to tetanus prone wounds.

【 授权许可】

CC BY   
© Donken et al.; licensee BioMed Central Ltd. 2014