Barriers to adherence to cystic fibrosis infection control guidelines
Barriers to adherence to cystic fibrosis infection control guidelines
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DOI：
10.1002/ppul.20876
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发表时间：
2008-09-01
影响因子：
3.1
通讯作者：
Saiman, Lisa
中科院分区：
文献类型：
--
作者：
Garber, Elizabeth;Desai, Manisha;Saiman, Lisa
背景：2003 年，美国囊性纤维化 (CF) 基金会发布了修订后的循证感染控制指南。我们试图评估护理 CIF 患者的医疗保健专业人员 (HCP) 在遵守这些指南时遇到的潜在障碍。方法：从 2004 年 4 月到 2005 年 12 月，对美国随机选择的 CF 中心的 HCP 进行了知识、态度和实践调查，以探讨遵守选定指南的潜在障碍：(1) 每季度从 CF 患者中获取培养物，(2) 阻止 CF 患者在住院期间进行社交活动，(3) 对患者和家属进行手部卫生教育，(4) 教育患者和家属清洁和消毒家用雾化器，以及 (5) 清洁诊所检查CF 患者之间的房间。结果：调查由来自 25 个地点的 528 名 HCP 完成（每个地点 5-50 名受访者）。只有 60% 的受访者了解这些指南，但尽管了解，但仍有 31-47% 的受访者不熟悉具体指南。自我报告的依从性很低；只有 23-63% 的受访者表示在超过 75% 的时间/机会中实践了所选指南。受访者普遍缺乏自我效能感，即对充分执行指南缺乏信心。获得指南副本与提高对建议的一致性和提高自我效能有关 结论：需要采取策略来减少遵守 CF 感染控制指南的障碍。策略可以包括通过加强教育和技能研讨会来提高质量的举措、在 CF 中心之间分享成功的干预措施以及将依从性与改善患者治疗效果联系起来。
Background: In 2003, the American Cystic Fibrosis (CF) Foundation published revised, evidence-based guidelines for infection control. We sought to assess potential barriers to adherence to these guidelines experienced by health care professionals (HCPs) caring for CIF patients. Methods: From April 2004 to December 2005, a knowledge, attitude, and practice survey was administered to HCPs at randomly selected CF centers in the United States to explore potential barriers to adherence to selected guidelines: (1) obtaining quarterly cultures from CF patients, (2) discouraging socialization among CF patients during hospitalization, (3) educating patients and families about hand hygiene, (4) educating patients and families to clean and disinfect home nebulizers, and (5) cleaning the clinic exam rooms between CF patients. Results: The survey was completed by 528 HCPs from 25 sites (5-50 respondents per site). Only 60% of respondents were aware of the guidelines, but despite awareness, 31-47% were unfamiliar with the specific guidelines. Self-reported adherencewas low; only 23-63% of respondents reported practicing the selected guidelines > 75% of the time/opportunities. Lack of self-efficacy, that is, confidence in adequately performing the guidelines, was commonly experienced by respondents. Access to a copy of the guidelines was associated with increased agreement with the recommendations and increased self-efficacy Conclusions: Strategies to reduce barriers to adherence to CF infection control guidelines are needed. Strategies could include quality improvement initiatives with enhanced education and skills workshops, sharing successful interventions among CF centers, and linking adherence to improved patient outcomes.