Knowledge and understanding of patients and health care workers about multi-resistant organisms

Santiano, Nancy; Caldwell, Jennifer; Ryan, Emina; Smuts, Arene; Schmidt, H

doi:10.1071/hi13027

Cited by 5 publications

(7 citation statements)

References 17 publications

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“…A small but growing number of papers have explored patients' knowledge and perceptions of risk around HAI 22,28 and the negative and positive elements of patients' experiences of source-isolation. 11,29 Our findings contribute to this literature.…”

Section: Discussionmentioning

confidence: 99%

“…Consistent with other research, we found that a lack of accurate, accessible and timely information about MROs contributed to frustration and confusion about IPC. 10,11,22 Most participants in this study felt they had not been adequately informed about how they could prevent MRO transmission. This does not necessarily mean they were not told at some point; they may have been overwhelmed by their illness or the impact of being placed in isolation, so information may not have been retained.…”

Section: Discussionmentioning

confidence: 99%

“…Perhaps this was due to discomfort around discussing HAI. 22 Healthcare providers need support and strategies to communicate the implications of colonisation, including ways to avoid subsequent infection and to reduce transmission, to patients, without unduly frightening them. 42 There have been recent calls to limit source-isolation for certain MRO-colonised patients in endemic, non-outbreak settings and some US hospitals have abandoned it in favour of greater emphasis on compliance with standard precautions, especially hand hygiene.…”

Section: Discussionmentioning

confidence: 99%

“…14,[16][17][18] However, some researchers have suggested that deficits in patients' knowledge and understanding of MRO transmission and infection prevention and control (IPC) strategies, such as hand hygiene and source-isolation, may influence patient adherence. [19][20][21][22][23] The aim of this paper is to explore patients' awareness, understandings and observance of sourceisolation practices and directives. Such insights may broaden clinicians' understandings of patient activities that impact upon IPC and may encourage them to support patients as more active partners in reducing infection transmission.…”

Section: Introductionmentioning

confidence: 99%

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Should I stay or should I go? Patient understandings of and responses to source-isolation practices

Wyer¹,

Iedema²,

Jorm³

et al. 2015

Patient Experience Journal

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Should I stay or should I go? Patient understandings of and responses to source-isolation practices

Wyer¹,

Iedema²,

Jorm³

et al. 2015

Patient Experience Journal

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“…48 However, the relationships are complex, and multiple organisational and management factors, such as clinical leadership and staffing, are also known to have a significant impact on infection control in hospitals. 49 Staff infection control knowledge 50 and risk perceptions of HCAI within different clinical environments may also influence HCAI rates. 51 Models of nursing may also be an important factor; for example, the 'cohorting' of patients, by grouping together infectious patients and nursing them within an area of a hospital ward to reduce spread of infection, can be more easily achieved with single rooms.…”

Section: Introductionmentioning

confidence: 99%

Evaluating a major innovation in hospital design: workforce implications and impact on patient and staff experiences of all single room hospital accommodation

Maben

Griffiths

Penfold

et al. 2015

Health Services and Delivery Research

177

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BackgroundNew hospital design includes more single room accommodation but there is scant and ambiguous evidence relating to the impact on patient safety and staff and patient experiences.ObjectivesTo explore the impact of the move to a newly built acute hospital with all single rooms on care delivery, working practices, staff and patient experience, safety outcomes and costs.Design(1) Mixed-methods study to inform a pre-/post-‘move’ comparison within a single hospital, (2) quasi-experimental study in two control hospitals and (3) analysis of capital and operational costs associated with single rooms.SettingFour nested case study wards [postnatal, acute admissions unit (AAU), general surgery and older people’s] within a new hospital with all single rooms. Matched wards in two control hospitals formed the comparator group.Data sourcesTwenty-one stakeholder interviews; 250 hours of observation, 24 staff interviews, 32 patient interviews, staff survey (n = 55) and staff pedometer data (n = 56) in the four case study wards; routinely collected data at ward level in the control hospitals (e.g. infection rates) and costs associated with hospital design (e.g. cleaning and staffing) in the new hospital.Results(1) There was no significant change to the proportion of time spent by nursing staff on different activities. Staff perceived improvements (patient comfort and confidentiality), but thought the new accommodation worse for visibility and surveillance, teamwork, monitoring, safeguarding and remaining close to patients. Giving sufficient time and attention to each patient, locating other staff and discussing care with colleagues proved difficult. Two-thirds of patients expressed a clear preference for single rooms, with the benefits of comfort and control outweighing any disadvantages. Some patients experienced care as task-driven and functional, and interaction with other patients was absent, leading to a sense of isolation. Staff walking distances increased significantly after the move. (2) A temporary increase in falls and medication errors within the AAU was likely to be associated with the need to adjust work patterns rather than associated with single rooms, although staff perceived the loss of panoptic surveillance as the key to increases in falls. Because of the fall in infection rates nationally and the low incidence at our study site and comparator hospitals, it is difficult to conclude from our data that it is the ‘single room’ factor that prevents infection. (3) Building an all single room hospital can cost 5% more but the difference is marginal over time. Housekeeping and cleaning costs are higher.ConclusionsThe nature of tasks undertaken by nurses did not change, but staff needed to adapt their working practices significantly and felt ill prepared for the new ways of working, with potentially significant implications for the nature of teamwork in the longer term. Staff preference remained for a mix of single rooms and bays. Patients preferred single rooms. There was no strong evidence that single rooms had any impact on patient safety but housekeeping and cleaning costs are higher. In terms of future work, patient experience and preferences in hospitals with different proportions of single rooms/designs need to be explored with a larger patient sample. The long-term impact of single room working on the nature of teamwork and informal learning and on clinical/care outcomes should also be explored.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Understanding patient and healthcare worker experiences and perspectives of multidrug-resistant organisms

Watson

Tsindos

Peleg

et al. 2023

JAC-Antimicrobial Resistance

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Objectives Transmission of MDR organisms (MROs) such as carbapenemase-producing Enterobacteriaceae (CPE) and VRE in healthcare facilities is a major issue globally. Knowledge gaps exist, including the impact of these microorganisms on patients, and healthcare worker understanding of infection control approaches for MROs. This study aimed to explore patient and healthcare worker experiences and perspectives of MROs. Methods A sequential exploratory mixed-methods study was performed at a large metropolitan acute and subacute hospital. This involved semi-structured face-to-face interviews with patients with confirmed MROs to explore their understanding of these microorganisms and perceptions of their time in hospital. Healthcare workers participated in an online survey about their understanding of MROs and the care of patients with these microorganisms. Qualitative data were analysed using the COM-B framework, and were triangulated with the descriptive quantitative analysis. Results The overarching theme from the triangulated data was uncertainty amongst both patients and staff about MROs. Insufficient explanations from staff left patients lacking a proper understanding of their diagnosis, and patients felt that staff did not always follow isolation protocols. Staff felt they did not receive enough education on MROs. However, patients felt that the overall care they received was very good, and most valued the privacy gained from being in isolation. Conclusions This study demonstrates that there is a need to focus on new strategies of communication with patients and staff education to improve understanding of MROs and increase adherence to protocols.

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Knowledge and understanding of patients and health care workers about multi-resistant organisms

Cited by 5 publications

References 17 publications

Should I stay or should I go? Patient understandings of and responses to source-isolation practices

Should I stay or should I go? Patient understandings of and responses to source-isolation practices

Evaluating a major innovation in hospital design: workforce implications and impact on patient and staff experiences of all single room hospital accommodation

Understanding patient and healthcare worker experiences and perspectives of multidrug-resistant organisms

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