Nursing staff perceptions of methicillin-resistant Staphylococcus aureus and infection control in a long-term care facility
Nursing staff perceptions of methicillin-resistant Staphylococcus aureus and infection control in a long-term care facility
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DOI：
10.1016/j.jamda.2008.02.003
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发表时间：
2008-06-01
影响因子：
7.6
通讯作者：
Richards, Chesley
中科院分区：
文献类型：
--
作者：
Wolf, Rachel;Lewis, Donna;Richards, Chesley
目的：评估护理人员对耐甲氧西林金黄色葡萄球菌（MRSA）、感染控制和预防策略、感染控制障碍和感染控制资源的认知。设计：横断面混合方法研究环境：亚特兰大退伍军人事务（VA）长期护理机构（LTCF）。参与者：2006年8月在长期护理基金工作的42名直接护理人员。测量：健康信念模型（HBM）指导了6个焦点小组讨论的发展，并结合了评估5种IC实践、风险认知和IC信息来源的定量形式。结果：只有59%的参与者认为MRSA对患者构成风险。自我报告的IC实践的一致性因具体行为而异。据报道，缺乏物资（26%）和缺乏信息/沟通（24%）是IC的主要障碍。所有参与者都将患者行为视为障碍，并且所有人都对MRSA和IC的额外教育感兴趣。与护理助理（NAs）相比，护士更频繁地将IC专业人员报告为最可信的信息源（60%对0%，P < 0.005）；NAs更容易信任主管护士（77%对4%，P < 0.001）。结论：这些结果表明，护理人员对MRSA的真正威胁和感染传播的认知，将推动这一高危人群的IC预防行为，以及护理人员的IC实践存在差异。本研究提供了在ltcf中实施多层次、多维集成电路所需的复杂教育和其他策略的见解。
Objectives: To assess perceptions of nursing staff regarding methicillin-resistant Staphylococcus aureus (MRSA), infection control (IC) and prevention strategies, barriers to IC, and IC resources.Design: Cross-sectional mixed methods study Setting: Atlanta Veterans Affairs (VA) long-term care facility (LTCF).Participants: Forty-two direct-care nursing staff employed at the LTCF during August 2006.Measurements: Health Belief Model (HBM) guided the development of 6 focus group discussions combined with a quantitative form assessing 5 IC practices, risk perceptions, and sources of IC information.Results: Only 59% of participants perceived that MRSA posed a risk to patients. Consistency of self-reported IC practices varied by specific behavior. Lack of supplies (26%) and lack of information/communication (24%) were reported as primary barriers to IC. All participants perceived patient behavior as a barrier, and all were interested in additional education about MRSA and IC. Comparing nurses with nursing assistants (NAs), nurses more frequently reported the IC professional as the most trusted information source (60% versus 0%, P < .005); NAs were more likely to trust the charge nurse (77% versus 4%, P < .001).Conclusion: These results suggest that the perceptions regarding the real threat of MRSA and infection transmission that would drive IC prevention behaviors in this high-risk population vary among nursing staff, as do nursing staff IC practices. This study provides insight into the complex educational and other strategies needed to implement multilevel, multidimensional IC in LTCFs.