Methicillin-Resistant Staphylococcus aureus Eradication and Decolonization in Children Study (Part 1): Development of a Decolonization Toolkit With Patient and Parent Advisors.
Methicillin-Resistant Staphylococcus aureus Eradication and Decolonization in Children Study (Part 1): Development of a Decolonization Toolkit With Patient and Parent Advisors.
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DOI：
10.2196/14974
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发表时间：
2020-05-20
影响因子：
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通讯作者：
Musey, Paul I
中科院分区：
文献类型：
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作者：
Moore, Courtney M;Wiehe, Sarah E;Musey, Paul I
背景：社区获得性耐甲氧西林金黄色葡萄球菌（MRSA）皮肤和软组织感染影响许多健康儿童。这些儿童中有相当一部分住院并需要手术切开和引流。一旦被送回家，这些儿童和家庭就被要求完成繁重的家庭非殖民化和卫生程序，以努力防止高复发感染率。目的：儿童耐甲氧西林金黄色葡萄球菌根除和去菌落（MEDiC）研究的这一组成部分旨在开发一个工具包，以帮助MEDiC研究参与者在家中完成MRSA去菌落和卫生程序（MEDiC工具包）。方法：采用以人为本的设计方法，5名因皮肤感染接受I&D手术的青少年（10-18岁）和11名因皮肤感染接受I&D手术的儿童家长参加了一个4小时的小组研讨会。本次研讨会涵盖并分析了以下主题：(1)对MRSA去菌落程序的态度；(2)实施MRSA去菌落和卫生程序的障碍。该团队分析了研讨会期间创建的音频和工件，并综合了他们的发现，为MEDiC工具包的创建提供了信息。结果：讲习班活动揭示了成功完成非殖民化和卫生程序的障碍：缺乏分步指导，家中缺乏适当的工具，对不良事件的担忧，对卫生程序某些方面缺乏控制，以及普遍难以协调所有程序。其中许多问题都可以作为MEDiC工具包的一部分加以解决。此外，讲习班表明，关于非殖民化的有效沟通必须解决对漂白剂影响的关切，提供详细信息，说明具体的非殖民化和卫生规程步骤的原因，并包括逐步说明（最好通过录像）。结论：通过与患者和家属的直接接触，我们能够更好地了解如何支持家庭实施MRSA去殖民化和卫生方案。此外，我们能够更好地了解如何就MRSA去殖民化和卫生协议进行沟通。有了这些知识，我们创建了一个强大的工具包，使用患者驱动的语言和视觉效果，通过实施这些协议来帮助支持患者和家属。试验注册：ClinicalTrials.gov NCT02127658；https://clinicaltrials.gov/ct2/show/NCT02127658。
BACKGROUND: Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections affect many healthy children. A significant number of these children are hospitalized and require surgical incision and drainage (I&D). Once sent home, these children and families are asked to complete burdensome home decolonization and hygiene procedures in an effort to prevent the high rate of recurrent infections.OBJECTIVE: This component of the Methicillin-resistant Staphylococcus aureus Eradication and Decolonization in Children (MEDiC) study aimed to develop a toolkit to assist MEDiC study participants in completing MRSA decolonization and hygiene procedures at home (the MEDiC kit).METHODS: In all, 5 adolescents (aged 10-18 years) who had undergone an I&D procedure for a skin infection and 11 parents of children who had undergone an I&D procedure for a skin infection were engaged in a 4-hour group workshop using a human-centered design approach. The topics covered in this workshop and analyzed for this paper were (1) attitudes about MRSA decolonization procedures and (2) barriers to the implementation of MRSA decolonization and hygiene procedures. The team analyzed the audio and artifacts created during the workshop and synthesized their findings to inform the creation of the MEDiC kit.RESULTS: The workshop activities uncovered barriers to successful completion of the decolonization and hygiene procedures: lack of step-by-step instruction, lack of proper tools in the home, concerns about adverse events, lack of control over some aspects of the hygiene procedures, and general difficulty coordinating all the procedures. Many of these could be addressed as part of the MEDiC kit. In addition, the workshop revealed that effective communication about decolonization would have to address concerns about the effects of bleach, provide detailed information, give reasons for the specific decolonization and hygiene protocol steps, and include step-by-step instructions (preferably through video).CONCLUSIONS: Through direct engagement with patients and families, we were able to better understand how to support families in implementing MRSA decolonization and hygiene protocols. In addition, we were able to better understand how to communicate about MRSA decolonization and hygiene protocols. With this knowledge, we created a robust toolkit that uses patient-driven language and visuals to help support patients and families through the implementation of these protocols.TRIAL REGISTRATION: ClinicalTrials.gov NCT02127658; https://clinicaltrials.gov/ct2/show/NCT02127658.