previous year. All dimensions improved significantly except for ‘adequate staffing’. And although the patient safety culture in general was more favourable after the DHPSP, differences increased among hospital and units within hospitals [87]. A more recent study in a Dutch university hospital related unit‐specific HH performance or improvement in HH to the safety culture of these units, observing correlation. Two of five units had bureaucratic or pathological (dismissive) safety cultures [130]. So there remains work to be done in this field. 10.7 Conclusions In the past two decades, HAI surveillance has been increasingly implemented, both in the Netherlands and in other countries. In this period, surveillance of HAI has facilitated the reduction of most types of HAI. Surveillance in combination with a patient safety programme has boosted both monitoring and infection prevention activities in Dutch hospitals. The introduction of best practices in the form of a bundle and the improvement in HH have been successful tools to reduce CRBSI in settings with relatively high rates. HAI surveillance remains relevant, particularly given the recent COVID‐19 pandemic and future demographic, or possibly, other changes. However, given the nowadays low incidence of most HAI, the current developments towards automated and therefore less labour‐intensive HAI surveillance is essential. 10 251 General Discussion
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