Addressing multidrug resistant pathogens in pediatric palliative care patients—the nurses point of view: A qualitative study

Schmidt, P; Hartenstein-Pinter, Almut; Wager, Julia; Hasan, Carola; Zernikow, Boris

doi:10.1177/0269216319883981

Cited by 8 publications

(6 citation statements)

References 30 publications

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“…Nevertheless, the high prevalence of MDRO colonisation in our study population may highlight the importance of antibiotic stewardship in children with life‐limiting conditions to reduce the emergence and spread of MDRO in the long term 23 . Each prevented occurrence or spread of MDRO prevents restrictions for PPC patients and their families as well as more effort regarding patient care for staff members 24 …”

Section: Discussionmentioning

confidence: 91%

“…23 Each prevented occurrence or spread of MDRO prevents restrictions for PPC patients and their families as well as more effort regarding patient care for staff members. 24 The hygiene concept PALLINI is risk adapted and uses a range of predictors to decide which patient is cared for with barrier nursing until screening results are available. Results of this study showed that only 'history of a positive MDRO screening' is a significant predictor.…”

Section: Discussionmentioning

confidence: 99%

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Multidrug‐resistant organisms in paediatric palliative care patients – Prevalence, risk factors and the impact of a liberal hygiene concept

Schmidt

Hasan

Mauritz

et al. 2022

J Paediatrics Child Health

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Aim Multidrug‐resistant organisms (MDRO) deserve special attention in health‐care facilities for children with life‐limiting conditions because these children have an increased risk for colonisation. To avoid nosocomial transmissions to other inpatients, single‐room isolation is usually recommended. In the context of paediatric palliative care (PPC), such isolation counters the aim of participation in social activities for the patients. This study aimed to determine the prevalence of MDRO, the predictive value of risk factors and the incidence of nosocomial infections and nosocomial colonisations on a PPC inpatient unit applying a special hygiene concept that enables participation in social activities through risk‐adaption and barrier nursing. Methods Two‐year surveillance with MDRO screening of all intakes (N = 386) of a PPC unit on the day of admission and discharge. To determine the predictive value of pre‐defined risk factors, logistic regression analyses were calculated. Receiver operating characteristic analyses were performed to determine the predictive power of the number of risk factors on the presence of MDRO. Results The rate of MDRO colonisation at admission was 12.7%; previous positive MDRO screening was the only significant individual risk factor. Over the 2‐year period, no MDRO‐related nosocomial infections occurred; nosocomial colonisation incidence density was 0.6. Conclusion Results demonstrate that patients with at least one risk factor have to be cared for by barrier nursing until MDRO screening results are negative. Following these guidelines prevents nosocomial MDRO transmission.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Multidrug‐resistant organisms in paediatric palliative care patients – Prevalence, risk factors and the impact of a liberal hygiene concept

Schmidt

Hasan

Mauritz

et al. 2022

J Paediatrics Child Health

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“…Seven studies were identified that focused on paediatric nurses' role in AMS (Table 4). 9,11,[57][58][59][60][61] Themes explored in these studies were: (1) nurses' understanding and beliefs of AMS Roles, and (2) barriers to nurses taking a greater role in AMS.…”

Section: Nurses and Antimicrobial Stewardshipmentioning

confidence: 99%

Paediatric nurses’, children's and parents’ adherence to infection prevention and control and knowledge of antimicrobial stewardship: A systematic review

Kilpatrick

Hutchinson

Manias

et al. 2021

American Journal of Infection Control

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Introduction: Infection prevention and control precautions help to decrease microbial transmission, and through the appropriate use of antibiotics, Antimicrobial Stewardship programs aim to decrease the prevalence and emergence of Antimicrobial Resistance. Methods: A systematic review was undertaken to critically appraise and synthesise evidence for nurses', children's and parents' knowledge and understanding of antimicrobial stewardship, and of infection prevention and control in acute paediatric care settings. The Preferred Reporting Items for Systematic reviews and Meta-Analyses guided the review. Studies were included if they examined the factors that contributed to nurses' adherence to, or consumers' practice in relation to, antimicrobial stewardship and infection prevention and control. Results: Of the 16,957 papers identified, 50 studies conducted in acute paediatric settings met the eligibility criteria, and were included. Most studies were of low methodological quality. Fourteen studies evaluated nurses' knowledge and self-reported adherence to Infection Prevention and Control principles and identified consistent practice gaps by nurses. Six studies evaluating the effectiveness of education programs reported modest improvements in nurses' knowledge and adherence to infection prevention and control. There were 15 studies, that investigated consumers' involvement in infection prevention and control that identified the following themes: Consumer knowledge and attitudes to infection prevention and control and transmissionbased precautions, and parents' willingness to take an active role in infection prevention. Six studies focused on paediatric nurses' role in antimicrobial stewardship, exploring the following themes: (1) nurses' understanding and beliefs of antimicrobial stewardship roles, and (2) barriers to nurses taking a greater role in antimicrobial stewardship. Nine studies explored the role of consumers in antimicrobial stewardship and identified consumers' misconceptions about the benefits and downplayed concerns regarding antibiotic use. Discussion: Although consumers articulated a willingness to be actively involved in infection prevention, observed practice remained lower than that required to consistently prevent infection transmission. Conclusion: These findings highlight a critically important gap in current practice. In relation to optimal use of antimicrobials, although paediatric nurses were involved in supporting antimicrobial stewardship processes and educating consumers, they identified limited antimicrobial stewardship knowledge. Consumers appeared to lack understanding about the benefits of antibiotics and negated concerns regarding antibiotic use.

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“…Pflegekräfte und andere Mitglieder des multiprofessionellen Teams können ohne Schutzkleidung in das Zimmer eintreten: solange sie nichts berühren und solange sie keinen direkten Kontakt zum Kind haben. Damit ist ein spontaner Austausch möglich, der sowohl den Familien als auch den Pflegekräften entgegenkommt [10]. Trotz Abstand entsteht dabei eine zugewandte und offene Atmosphäre zwischen Pflegekräften und Familien: ein Augenblick geteilter Teilhabe.…”

Section: Grenzen Im Alltagunclassified

Teilhaben trotz multiresistenter Erreger (MRE)

Hartenstein-Pinter¹,

Stening²,

Garske³

et al. 2021

JuKiP - Ihr Fachmagazin für Gesundheits- und Kinderkrankenpfleg

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Während der stationären pädiatrischen Palliativversorgung profitieren die Familien vor allem vom sozialen Miteinander auf der Station. Dass Kinder und ihre Familien trotz einer Besiedelung mit einem multiresistenten Erreger (MRE) auch daran teilhaben können, ermöglicht ein eigens dafür entwickeltes Hygienekonzept: PALLINI. Wie dieses Hygienekonzept umgesetzt wurde und wie PALLINI den Alltag der Pflegekräfte beeinflusst, davon berichten die Autorinnen in diesem Beitrag.

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Addressing multidrug resistant pathogens in pediatric palliative care patients—the nurses point of view: A qualitative study

Cited by 8 publications

References 30 publications

Multidrug‐resistant organisms in paediatric palliative care patients – Prevalence, risk factors and the impact of a liberal hygiene concept

Multidrug‐resistant organisms in paediatric palliative care patients – Prevalence, risk factors and the impact of a liberal hygiene concept

Paediatric nurses’, children's and parents’ adherence to infection prevention and control and knowledge of antimicrobial stewardship: A systematic review

Teilhaben trotz multiresistenter Erreger (MRE)

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