Methicillin-resistant Staphylococcus aureus: psychological impact of hospitalization and isolation in an older adult population

Tarzi, Sarah Lilly Farah; Kennedy, Paul; Stone, Sheldon; Evans, Michael A.

doi:10.1053/jhin.2001.1098

Cited by 132 publications

(109 citation statements)

References 16 publications

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“…22,23 The results of our global assessment of current MRSA containment policies in German palliative care institutions do add evidence from a professional caregivers' and institutional perspective to the cross-border notion of negative effects of such policies on patients both in the palliative care 5,7,8 and in other settings. 1,2,18 Next steps should begin with conducting a multi-centre mixed-method investigation of affected patients' and relatives' opinions on their experience of the MRSA regimen to estimate the magnitude of the problem within the palliative care settings. Second, clinical data obtained from carefully matched cohorts may clarify the significance of MRSA eradication, isolation protocols and treatment.…”

Section: Discussionmentioning

confidence: 99%

Methicillin-resistant Staphylococcus aureus (MRSA) management in palliative care units and hospices in Germany: A nationwide survey on patient isolation policies and quality of life

et al. 2011

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Background: For palliative care settings, little is known about the benefits of specific methicillin-resistant Staphylococcus aureus containment regimens and the burdens patient isolation imposes on affected patients, their families, and professional caregivers. Aim: To explore the current practice of MRSA management and its impact on inpatients' quality of life as perceived by professional caregivers. Design: Survey of inpatient palliative care institutions using 23-item questionnaires (infrastructural data: six items, management process: 14, clinical significance: three). Setting/participants: All palliative care units (179) and hospices (181) listed in Germany's directory of palliative care services. The c 2 test was used to test for differences; significance level: p ≤ 0.05. Results: 229 of 360 questionnaires were returned. More than 90% of the responding institutions employed specific MRSA protocols. Lack of resources was a more important issue for palliative care units than for hospices regarding availability of single rooms (p = 0.002) and staffing (p = 0.004). Compared to hospices, palliative care units more frequently isolated MRSA patients (p = 0.000), actively treated colonization (p = 0.026), assessed the efficacy of eradication (p = 0.000), provided information on MRSA management to patients (p = 0.014) and relatives (p = 0.001), more often restricted patients' activities (p = 0.000), and reported a negative impact on quality of life (p = 0.000). Conclusions: Rigorously applied MRSA protocols impose significant burdens at the end of life. Research on clinical outcomes including quality of life may identify interventions of questionable benefit. The issue of handling MRSA should be studied as a model for the management of other highly complex conditions and special needs such as patient isolation.

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Section: Discussionmentioning

confidence: 99%

Methicillin-resistant Staphylococcus aureus (MRSA) management in palliative care units and hospices in Germany: A nationwide survey on patient isolation policies and quality of life

et al. 2011

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“…Studies that have explored patients' experiences of being nursed in single room isolation, due to infection while in hospital, have identified adverse effects including boredom, lowered or disturbed mood, and feelings of stigma, along with anxiety about passing the infections to relatives and carers. [91][92][93][94] An integrated review of nineteen studies that explored patients' experiences of infection and/or isolation identified some key common themes. These included a perceived lack of consistent information about the infection, poor understanding of the infection by health care staff, associated fear and stigma, and isolation.…”

Section: Patient-focused Perspectivesmentioning

confidence: 99%

Reducing the risk of infection associated with vascular access devices through nanotechnology: a perspective

Zhang¹,

Keogh²,

Rickard³

2013

IJN

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Intravascular catheter-related infections are still a major problem in health care and are associated with significant morbidity, mortality, and additional cost. The formation of microbial biofilm on catheters makes these infections particularly complicated, as microbial cells that detach from the biofilm can lead to infection, and because these microorganisms are highly resistant to many antimicrobial agents; thus, catheter removal is often required to successfully treat infection. To reduce the risks of catheter-related infections, many strategies have been applied, such as improvements in aseptic insertion and post-insertion care practices, implantation techniques, and antibiotic coated or impregnated materials. However, despite significant advances in using these methods, it has not been possible to completely eradicate biofilm infections. Currently, nanotechnology approaches seem to be among the most promising for preventing biofilm formation and resultant catheter-related bloodstream infection (especially with multi-resistant bacterial strains). In this review, current knowledge about catheter technology and design, the mechanisms of catheter-related bloodstream infection, and the insertion and care practices performed by medical staff, are discussed, along with novel, achievable approaches to infection prevention, based on nanotechnology.

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“…For example, patients who have negative perceptions about their illness often have increased future disability and slower recovery independent of the initial medical severity. 27 A review of the literature 28 and several studies have shown that contact isolation can have a negative psychological impact on patients, including decreased patient satisfaction with care, 29,30 more anxiety or depression, [31][32][33][34] increased anger about their infection and being worried about passing their infection on to family. 25 Increasing the knowledge level in patients and their families may help to reduce these fears and negative perceptions about being placed in isolation.…”

Section: Evans Et Al a Patient Education Intervention On Mrsamentioning

confidence: 99%

Implementing a patient education intervention about Methicillin-resistantStaphylococcus aureusprevention and effect on knowledge and behavior in veterans with spinal cord injuries and disorders: A pilot randomized controlled trial

Evans¹,

Hill²,

Guihan

et al. 2013

The Journal of Spinal Cord Medicine

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Objectives: To assess the feasibility and effect of a nurse-administered patient educational intervention about Methicillin-resistant Staphylococcus aureus (MRSA) prevention on knowledge and behavior of Veterans with spinal cord injuries and disorders (SCI/D). Design: Blinded, block-randomized controlled pilot trial. Setting: Two Department of Veterans Affairs (VA) SCI Centers. Participants: Veterans were recruited March-September 2010 through referral by a healthcare provider from inpatient, outpatient, and residential care settings. Intervention: Thirty participants were randomized to the nurse-administered intervention and 31 to the usual care group. The intervention included a brochure and tools to assist nurses in conducting the education. Outcome measures: Pre-and post-intervention measurement of knowledge and behaviors related to MRSA and prevention strategies and feasibility measures related to implementation. Results: Participants were primarily male (95.1%), white (63.9%), with tetraplegia (63.9%) and mean age and duration of injury of 64.3 and 20.5 years, respectively. The intervention groups mean knowledge score significantly increased between pre-and post-test (mean change score = 1.70, 95% confidence interval, CI 0.25-3.15) while the usual care groups score did not significantly change (mean change score = 1.45, 95% CI −0.08-2.98). However, the mean knowledge change between intervention and usual care groups was not

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Methicillin-resistant Staphylococcus aureus: psychological impact of hospitalization and isolation in an older adult population

Cited by 132 publications

References 16 publications

Methicillin-resistant Staphylococcus aureus (MRSA) management in palliative care units and hospices in Germany: A nationwide survey on patient isolation policies and quality of life

Methicillin-resistant Staphylococcus aureus (MRSA) management in palliative care units and hospices in Germany: A nationwide survey on patient isolation policies and quality of life

Reducing the risk of infection associated with vascular access devices through nanotechnology: a perspective

Implementing a patient education intervention about Methicillin-resistantStaphylococcus aureusprevention and effect on knowledge and behavior in veterans with spinal cord injuries and disorders: A pilot randomized controlled trial

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