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Du X, Song Y, Wang H, Chen W, Wang L, Feng X, Zhang X, Song C. Research on the relationship between nurses' compliance with standard precautions, servant leadership and emotional exhaustion: A cross-sectional survey. J Adv Nurs 2024; 80:2822-2834. [PMID: 38186045 DOI: 10.1111/jan.16020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/27/2023] [Accepted: 11/30/2023] [Indexed: 01/09/2024]
Abstract
AIM This study aimed to analyse the effects of servant leadership on nurses' emotional failure and compliance with standard precautions and to explore the moderating effect of individual resilience. DESIGN A cross-sectional survey. METHODS This descriptive cross-sectional study was conducted from October 9 to November 1, 2022. The convenience sampling method was used to collect questionnaire data from 924 clinical nurses in a third-class general hospital in Chongqing, China. RESULTS The emotional exhaustion and compliance with standard precautions were at the general level. Servant leadership mediated by emotional exhaustion had a significant positive predictive effect on compliance with standard precautions. Personal resilience played a negative moderating role in the relationship between servant leadership and emotional exhaustion. For nurses with low resilience, servant leadership had a greater impact on emotional exhaustion. CONCLUSION The current compliance with standard precautions for clinical nurses is not high due to emotional exhaustion. The level of servant leadership can alleviate nurses' emotional exhaustion and improve compliance with standard precautions. Especially for nurses with low personal resilience, the care and support of department leaders are needed. IMPACT We found that the compliance with standard precautions is not high, and the link between emotional exhaustion, servant leadership and compliance with standard precautions provides a basis for further patient care. NO PATIENT OR PUBLIC CONTRIBUTION There was no patient or public involvement. IMPACT STATEMENT Nurses are the key population for hospital infection prevention and control, and their level of compliance with standard precautions is of great significance for hospital infection prevention and control. However, in practice, nurses' compliance with standard precautions is generally low. Most of the previous studies on nurses' compliance with standard precautions were conducted from the perspective of individual nurses, based on the staff's 'knowledge, belief, and action' to study the current status of compliance with standard precautions and the factors affecting adherence, with less attention paid to the influence of psychological, environmental, and organizational factors. Therefore, the study focuses on the impact of servant leadership and emotional exhaustion on standard precautionary adherence, which is of great significance for good care management at the organizational level. It also explored how the impact of servant leadership on emotional exhaustion varies across levels of resilience, which is important for accurately identifying different types of nursing staff and targeting assistance.
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Affiliation(s)
- Xin Du
- Medical Center of Hematology, Xinqiao Hospital, State Key Laboratory of Trauma and Chemical Poisoning, Chongqing Key Laboratory of Hematology and Microenvironment, Army Medical University, Chongqing, China
| | - Yang Song
- Educational Science Research Institute of Huazhong University of Science and Technology, Chongqing Medical University, Chongqing, China
- Bidding Procurement Center, Chongqing Medical University, Chongqing, China
| | - Huan Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
- Development and Planning Department, Chongqing Medical University, Chongqing, China
| | - Wen Chen
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Lei Wang
- Orthopedics Department, Xinqiao Hospital of Army Medical University, Chongqing, China
| | - Xue Feng
- Medical Center of Hematology, Xinqiao Hospital, State Key Laboratory of Trauma and Chemical Poisoning, Chongqing Key Laboratory of Hematology and Microenvironment, Army Medical University, Chongqing, China
| | - Xi Zhang
- Medical Center of Hematology, Xinqiao Hospital, State Key Laboratory of Trauma and Chemical Poisoning, Chongqing Key Laboratory of Hematology and Microenvironment, Army Medical University, Chongqing, China
| | - Caiping Song
- President Office, Xinqiao Hospital of Army Medical University, Chongqing, China
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Ungar R, Gur-Arie R, Heriot GS, Jamrozik E. Burdens of infection control on healthcare workers: a scoping review. J Hosp Infect 2024; 146:76-81. [PMID: 38141665 DOI: 10.1016/j.jhin.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 12/25/2023]
Abstract
INTRODUCTION Hospital-acquired infections (HAIs) pose a significant risk to patients, and are a major focus of infection prevention and control policies (IPC). One under-recognized reason for the generally poor compliance with IPC is that it is burdensome for healthcare workers (HCWs). AIM To identify the burdens of IPC for HCWs. METHODS PubMed and CINAHL were searched for studies published in English since 2000 regarding compliance with IPC and the burdens associated with compliance. After screening 1018 initial results, 25 articles were included in the final review. RESULTS Evidence was found for burdens including dermatological complications, headaches, sensory symptoms and time pressure. Tools designed to measure compliance with IPC have limitations, and rarely assess the burdens of compliance. A strong safety culture predicted positive compliance, while knowledge of the underlying rationale for IPC had a non-linear relationship with compliance. CONCLUSION Future research should clarify IPC-related burdens and how these may be minimized to achieve better compliance.
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Affiliation(s)
- R Ungar
- Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - R Gur-Arie
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - G S Heriot
- Department of Infectious Diseases, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - E Jamrozik
- Ethox Centre and Pandemic Sciences Institute, University of Oxford, Oxford, UK; Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia; Monash Bioethics Centre, Monash University, Melbourne, Australia.
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Lommi M, De Benedictis A, Porcelli B, Raffaele B, Latina R, Montini G, Tolentino Diaz MY, Guarente L, De Maria M, Ricci S, Giovanniello D, Rocco G, Stievano A, Sabatino L, Notarnicola I, Gualandi R, Tartaglini D, Ivziku D. Evaluation of Standard Precautions Compliance Instruments: A Systematic Review Using COSMIN Methodology. Healthcare (Basel) 2023; 11:healthcare11101408. [PMID: 37239700 DOI: 10.3390/healthcare11101408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/26/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Standard precautions (SPs) are first-line strategies with a dual goal: to protect health care workers from occupational contamination while providing care to infected patients and to prevent/reduce health care-associated infections (HAIs). This study aimed at (1) identifying the instruments currently available for measuring healthcare professionals' compliance with standard precautions; (2) evaluating their measurement properties; and (3) providing sound evidence for instrument selection for use by researchers, teachers, staff trainers, and clinical tutors. METHODS We carried out a systematic review to examine the psychometric properties of standard precautions self-assessment instruments in conformity with the COSMIN guidelines. The search was conducted on the databases PubMed, CINAHL, and APA PsycInfo. RESULTS Thirteen instruments were identified. These were classified into four categories of tools assessing: compliance with universal precautions, adherence to standard precautions, compliance with hand hygiene, and adherence to transmission-based guidelines and precautions. The psychometric properties of instruments and methodological approaches of the included studies were often not satisfactory. Only four instruments were classified as high-quality measurements. CONCLUSIONS The available instruments that measure healthcare professionals' compliance with standard precautions are of low-moderate quality. It is necessary that future research completes the validation processes undertaken for long-established and newly developed instruments, using higher-quality methods and estimating all psychometric properties.
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Affiliation(s)
- Marzia Lommi
- UOC Care to the Person, Local Health Authority Roma 2, 00159 Rome, Italy
| | - Anna De Benedictis
- Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Barbara Porcelli
- UOC Care to the Person, Local Health Authority Roma 2, 00159 Rome, Italy
| | - Barbara Raffaele
- UOC Care to the Person, Local Health Authority Roma 2, 00159 Rome, Italy
| | - Roberto Latina
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, 90128 Palermo, Italy
| | - Graziella Montini
- UOC Care to the Person, Local Health Authority Roma 2, 00159 Rome, Italy
| | | | - Luca Guarente
- Department of Biomedicine and Prevetion, University Tor Vergata, 00133 Rome, Italy
| | - Maddalena De Maria
- Department of Biomedicine and Prevetion, University Tor Vergata, 00133 Rome, Italy
| | - Simona Ricci
- UOC Care to the Person, Local Health Authority Roma 2, 00159 Rome, Italy
| | - Dominique Giovanniello
- Department of Traslational Medical Sciences, University of Campania "Luigi Vanvitelli", 81100 Caserta, Italy
| | - Gennaro Rocco
- Centre of Excellence for Nursing Scholarship, Order of Nurses of Rome, 00136 Rome, Italy
- Department of Nursing, Catholic University "Our Lady of Good Counsel", 1000 Tirana, Albania
| | - Alessandro Stievano
- Centre of Excellence for Nursing Scholarship, Order of Nurses of Rome, 00136 Rome, Italy
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy
| | - Laura Sabatino
- Centre of Excellence for Nursing Scholarship, Order of Nurses of Rome, 00136 Rome, Italy
| | - Ippolito Notarnicola
- Centre of Excellence for Nursing Scholarship, Order of Nurses of Rome, 00136 Rome, Italy
| | - Raffaella Gualandi
- Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Daniela Tartaglini
- Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Dhurata Ivziku
- Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
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Compliance with standard precautions and associated factors among undergraduate nursing students at governmental universities of Amhara region, Northwest Ethiopia. BMC Nurs 2022; 21:375. [PMID: 36581879 PMCID: PMC9800055 DOI: 10.1186/s12912-022-01165-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 12/26/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Standard precautions are minimum infection control practices used to prevent the transmission of diseases and applied to all patient care. Nursing students are at high risk of exposure to occupational biologic hazards because they are obligated to provide care to patients admitted with unknown infection statuses. Compliance with standard precautions is an effective and efficient means of infection prevention. However, their compliance with standard precautions among nursing students is not known in Ethiopia. Therefore, this study aimed to assess compliance with standard precautions and associated factors among undergraduate BSc nursing students at governmental universities located in the Amhara Region, northwest Ethiopia. METHODS An institutional-based cross-sectional study was conducted among undergraduate BSc nursing students at the governmental universities located in Amhara Region, northwest Ethiopia, from April 15 to May 15, 2021. A simple random sampling technique was used to select 423 samples. Descriptive statistics were presented in text, tables, and charts. Multicollinearity and model fitness were checked. All variables were entered into multivariable logistic regression and a P-value of < 0.05 was considered to identify statistically significant factors. RESULT Around 221 (53.4%) of the study participants were males. Good compliance of nursing students towards standard precautions was 56.3% (95% CI = 51.4-60.9), which is significantly associated with good knowledge (AOR = 2.52, 95% CI = 1.61-3.94), a perceived safe workplace climate (AOR = 2.15, 95% CI = 1.24-3.71), and training or seminars related to standard precautions in the last six months (AOR = 1.52, 95% CI = 1.01-2.29). CONCLUSION The overall compliance of nursing students with standard precautions was low, with nearly half of the nursing students failing to comply with standard precautions. The major factors associated with good compliance were good knowledge, a perceived safe workplace, and having seminars or training in the last six months. Training, enhancing knowledge, and creating a safe hospital environment are recommended to improve nursing students' compliance with standard precautions.
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Meneguin S, Pollo CF, Melchiades EP, Ramos MSM, de Morais JF, de Oliveira C. Scale of Adherence to Good Hospital Practices for COVID-19: Psychometric Properties. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912025. [PMID: 36231328 PMCID: PMC9566148 DOI: 10.3390/ijerph191912025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/12/2022] [Accepted: 08/18/2022] [Indexed: 06/01/2023]
Abstract
To avoid hospital transmission, all COVID-19 prevention measures should be followed. This study aimed to evaluate the psychometric properties of a novel scale developed to assess adherence to good practices for COVID-19 in the hospital setting. A methodological cross-sectional study was conducted at a public hospital in the state of São Paulo, Brazil, with 307 healthcare providers. Data were collected using a questionnaire addressing sociodemographic/occupational data and the Adherence to Standard Precautions for COVID-19 scale. Cronbach's alpha coefficients and the intraclass correlation coefficients were used to measure internal consistency and temporal stability (test-retest analysis), respectively. Concurrent validity was evaluated using Spearman's correlation coefficients between the scores of the overall scale and its domains. Factorial structure was evaluated using exploratory factor analysis and goodness-of-fit of the model was tested using confirmatory factor analysis. Cronbach's alpha coefficients for the scale and its domains were higher than 0.7, except the psychosocial domain (0.61). All intraclass correlation coefficients were higher than 0.7. Strong correlations were found between the total score and the personal (0.84) and organizational (0.90) domains of the scale and a good correlation was found with the psychosocial domain (0.66). The fit of the multidimensional model was satisfactory for all parameters and the three-dimensional structure of the scale was confirmed by the fit of the factor loadings. The novel scale is a valid and reliable instrument for assessing adherence to good hospital practices for COVID-19.
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Affiliation(s)
- Silmara Meneguin
- Department of Nursing, Botucatu Medical School, Paulista State University, Botucatu 18618-687, SP, Brazil
| | - Camila Fernandes Pollo
- Department of Nursing, Botucatu Medical School, Paulista State University, Botucatu 18618-687, SP, Brazil
| | - Ediana Preisler Melchiades
- Department of Nursing, Botucatu Medical School, Paulista State University, Botucatu 18618-687, SP, Brazil
| | | | - José Fausto de Morais
- Faculty of Mathematics, Federal University of Uberlândia, Uberlândia 38400-902, MG, Brazil
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, University College London, London WC1E 6BT, UK
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Langeveld DTJC, Eilers DR, Haverkate MR, Ferreira DJA, de Veer DAJE, Timen A. Nursing care for patients carrying multi-drug resistant organisms: Experiences, intention to use protective equipment and ability to comply with measures. J Clin Nurs 2022. [PMID: 35799380 DOI: 10.1111/jocn.16443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 03/28/2022] [Accepted: 06/20/2022] [Indexed: 11/30/2022]
Abstract
AIMS The aims of the study were to explore the impact of caring for patients carrying multi-drug resistant organisms on nursing staff and identify factors predicting their intention to use personal protective equipment and their ability to comply with advised infection prevention and control measures. BACKGROUND Carriage of multi-drug resistant organisms and corresponding infection prevention and control measures have a major impact on patients. Limited research has been done to investigate the impact of caring for these patients on nursing staff. DESIGN A cross-sectional design. METHODS Online survey among Dutch nursing staff in various healthcare settings. Prediction analyses were conducted using random forest. The STROBE checklist was used preparing the manuscript. RESULTS 974 respondents were included. The majority of nursing staff reported to have experience in caring for patients carrying multi-drug resistant organisms. Relevant dilemmas in daily practice were identified. Important predictors of the intention to use protective equipment were practicing hand hygiene, usable protocols, favourable attitudes and perceptions, as well as knowledge. Important predictors of the ability to comply with advised measures were usable and findable protocols, a suitable work environment and practicing hand hygiene. CONCLUSION We have gained comprehensive insight into experiences, attitudes, perceptions, knowledge and dilemmas in daily practice of nursing staff caring for patients carrying multi-drug resistant organisms. To enhance their intention to use protective equipment and their ability to comply with advised measures, activities should focus on improving hand hygiene and the usability of protocols. Additionally, efforts are needed to improve knowledge, provide better resources and a more supportive work environment. All of which need to be specifically tailored to each healthcare setting. RELEVANCE TO CLINICAL PRACTICE The results can be used in the development of interventions to improve nursing care while reducing the unfavourable impact on nursing staff and supporting adherence to advised measures.
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Affiliation(s)
- Drs Tessa J C Langeveld
- Dutch Center for infectious Disease Control (LCI), National Institute for Public Health and Environment (RIVM), Bilthoven, The Netherlands.,Athena Institute, Faculty of Science, Vrije Universiteit (VU) Amsterdam, Amsterdam, The Netherlands
| | - Dr Renske Eilers
- Dutch Center for infectious Disease Control (LCI), National Institute for Public Health and Environment (RIVM), Bilthoven, The Netherlands
| | - Manon R Haverkate
- Dutch Center for infectious Disease Control (LCI), National Institute for Public Health and Environment (RIVM), Bilthoven, The Netherlands
| | - Dr José A Ferreira
- Dutch Department of Statistics, Informatics and Modelling, National Institute for Public Health and Environment (RIVM), Bilthoven, The Netherlands
| | - Dr Anke J E de Veer
- Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands
| | - Aura Timen
- Dutch Center for infectious Disease Control (LCI), National Institute for Public Health and Environment (RIVM), Bilthoven, The Netherlands.,Athena Institute, Faculty of Science, Vrije Universiteit (VU) Amsterdam, Amsterdam, The Netherlands
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Wong ELY, Ho KF, Dong D, Cheung AWL, Yau PSY, Chan EYY, Yeoh EK, Chien WT, Chen FY, Poon S, Zhang Q, Wong SYS. Compliance with Standard Precautions and Its Relationship with Views on Infection Control and Prevention Policy among Healthcare Workers during COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073420. [PMID: 33806138 PMCID: PMC8038100 DOI: 10.3390/ijerph18073420] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/23/2021] [Accepted: 03/23/2021] [Indexed: 12/20/2022]
Abstract
Background: Standard precautions prevent the spread of infections in healthcare settings. Incompliance with infection control guidelines of healthcare workers (HCWs) may increase their risk of exposure to infectious disease, especially under pandemics. The purpose of this study was to assess the level of compliance with the infection prevention and control practices among HCWs in different healthcare settings and its relationship with their views on workplace infection control measures during the COVID-19 pandemic. Methods: Nurses in Hong Kong were invited to respond to a cross-sectional online survey, in which their views on workplace infection and prevention policy, compliance with standard precautions and self-reported health during pandemics were collected. Results: The respondents were dissatisfied with workplace infection and prevention policy in terms of comprehensiveness (62%), clarity (64%), timeliness (63%), and transparency (60%). For the protective behavior, the respondents did not fully comply with the standard precautions when they were involved in medical care. Their compliance was relatively low when having proper patient handling (54%) and performing invasive procedures (46%). A multivariate analysis model proved that the level of compliance of the standard precautions was positively associated with the satisfaction on infection control and prevention policy among high risk group (0.020; 95% CI: 0.005–0.036), while older respondents had higher level of compliance among the inpatient and outpatient groups (coefficient range: 0.065–0.076). The higher level of compliance was also significantly associated with working in designated team and having chronic condition of the respondents among high-risk and inpatient groups. Conclusions: Standard precautions are the most important elements to reduce cross-transmission among HCWs and patients while the satisfaction on infection control and prevention policy would increase the compliance among the high-risk group. An overall suboptimal compliance and poor views on the infection prevention and control guidelines is a warning signal to healthcare system especially during pandemics.
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Affiliation(s)
- Eliza Lai-Yi Wong
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (D.D.); (A.W.-L.C.); (P.S.-Y.Y.); (E.-K.Y.)
- Correspondence: ; Tel.: +852-2252-8772
| | - Kin-Fai Ho
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (K.-F.H.); (E.Y.-Y.C.); (S.Y.-S.W.)
| | - Dong Dong
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (D.D.); (A.W.-L.C.); (P.S.-Y.Y.); (E.-K.Y.)
| | - Annie Wai-Ling Cheung
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (D.D.); (A.W.-L.C.); (P.S.-Y.Y.); (E.-K.Y.)
| | - Peter Sen-Yung Yau
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (D.D.); (A.W.-L.C.); (P.S.-Y.Y.); (E.-K.Y.)
| | - Emily Ying-Yang Chan
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (K.-F.H.); (E.Y.-Y.C.); (S.Y.-S.W.)
| | - Eng-Kiong Yeoh
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (D.D.); (A.W.-L.C.); (P.S.-Y.Y.); (E.-K.Y.)
| | - Wai-Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China;
| | - Frank Youhua Chen
- Department of Management Sciences, College of Business, City University of Hong Kong, Hong Kong, China;
| | - Simon Poon
- School of Computer Science, Faculty of Engineering, The University of Sydney, Hong Kong, China;
| | - Qingpeng Zhang
- School of Data Science, City University of Hong Kong, Hong Kong, China;
| | - Samuel Yeung-Shan Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (K.-F.H.); (E.Y.-Y.C.); (S.Y.-S.W.)
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Kim H, Park H. Compliance with Infection Prevention and Control Practice among Prospective Graduates of Nursing School in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052373. [PMID: 33804360 PMCID: PMC7967753 DOI: 10.3390/ijerph18052373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/26/2021] [Accepted: 02/27/2021] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to examine compliance with infection prevention and control practice and factors affecting compliance in nursing students who are about to graduate. A cross-sectional survey design was used. A total of 178 students from two nursing colleges in South Korea responded to self-reported questionnaires. Descriptive statistics, independent t-test, Pearson correlation, and multiple regression analysis were conducted. Mean score for compliance was 4.09 ± 0.43 out of 5. The highest score was on compliance with prevention of cross-infection (4.42 ± 0.54) and the lowest was on use of protective devices (3.86 ± 0.78). Non-occupational exposure scores on compliance subcategories were significantly higher than those for occupational exposure. Students' perception of safe environment for infection control and a positive attitude toward infection control predicted compliance significantly (β = 0.28, p < 0.001; β = 0.18, p = 0.014, respectively). The findings clarify that the level of infection control compliance among Korean nursing students is moderate. In order to increase the level of compliance, a climate that emphasizes a safe environment for healthcare-associated infections should be strengthened. In addition, nursing education should endeavor to develop a positive attitude toward infection prevention.
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Affiliation(s)
- Hyunjung Kim
- College of Nursing & Research Institute of Nursing Science, Hallym University, Gangwon-do 24252, Korea;
| | - Hyunju Park
- College of Nursing, Kangwon National University, Gangwon-do 24341, Korea
- Correspondence: ; Tel.: +82-10-4111-5895
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Abubakar S, Boehnke JR, Burnett E, Smith K. Examining instruments used to measure knowledge of catheter-associated urinary tract infection prevention in health care workers: A systematic review. Am J Infect Control 2021; 49:255-264. [PMID: 32707131 DOI: 10.1016/j.ajic.2020.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/20/2020] [Accepted: 07/20/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Catheter-associated urinary tract infection (CAUTI) is the most frequently occurring health care-associated infection among hospitalized patients. Adequate knowledge of CAUTI in health care workers supports effective prevention and control of the infection. This systematic review assesses instruments used to assess knowledge of CAUTI prevention in health care workers to inform future research. The catheter lifecycle model was used to evaluate the conceptual framework upon which the measurement instruments were based. Finally, the psychometric quality of these instruments was evaluated. METHODS Five electronic databases were searched for published studies and instruments. The COnsensus-based Standards for the selection of health status Measurement INstruments checklist was used to assess the psychometric quality reporting of the instruments. RESULTS Fifteen studies met the review inclusion criteria and 13 instruments were available for review. Most of the instruments did not address all knowledge components essential for CAUTI prevention as defined by the catheter lifecycle model. The psychometric quality of the instruments was not sufficiently evaluated. CONCLUSIONS Few instruments are available for CAUTI prevention knowledge measurement. The instruments were not closely aligned with the catheter lifecycle model as a framework. If CAUTI knowledge cannot be measured accurately using an effective instrument, this has the potential to impact negatively on clinical care and the focus of interventions. There is a need for a standardized instrument for the evaluation of CAUTI prevention knowledge so that targeted interventions can address knowledge deficits.
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Luna TDDCD, Pereira-Ávila FMV, Brandão P, Michinov E, Góes FGB, Caldeira NMVP, Gir E. Psychometric properties of the Brazilian version of the Standard Precautions Questionnaire for health professionals in Brazil. Rev Bras Enferm 2020; 73:e20190518. [PMID: 33263674 DOI: 10.1590/0034-7167-2019-0518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 04/24/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES to evaluate the psychometric properties of the Brazilian version of the Standard Precautions Questionnaire. METHODS this is a methodological study conducted with physicians and nursing professionals for the evaluation of psychometric properties. A reliability analysis was conducted using Cronbach's alpha. Exploratory factor analysis was performed and scores were analyzed using the known-groups method. RESULTS the scale was applied to 300 professionals: 88 nurses, 163 nursing technicians and 49 physicians. Cronbach's alpha was 0.71. All items presented satisfactory factor loading. Known-group validity showed sensitivity of differences in the scores of socio-cognitive factors, where nurses obtained a significant effect in scores of intention (4.77; p=0.000) and individual constraints (3.52; p=0.041) when compared to other health professionals. CONCLUSIONS satisfactory construct reliability and validity were obtained for the Brazilian version of the questionnaire, allowing a valid and reliable instrument for the assessment of socio-cognitive determinants of compliance with standard precautions.
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Affiliation(s)
| | | | - Priscila Brandão
- Universidade Federal Fluminense. Rio das Ostras, Rio de Janeiro, Brazil
| | | | | | | | - Elucir Gir
- Universidade de São Paulo. Ribeirão Preto, São Paulo, Brazil
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Vazquez-Alcaraz SJ, Rodriguez-Soto MC, Monroy-Salcedo RA, Cardenas-Delgado RK. Development and validation of an instrument to assess adherence to occupational health protocols in dentistry. J Dent Educ 2020; 85:331-340. [PMID: 33075848 DOI: 10.1002/jdd.12454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 08/31/2020] [Accepted: 10/06/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVES The purpose of this study was the creation and validation of an instrument to evaluate adherence to occupational health protocols used in dentistry that arise from official regulations and international recommendations on infection control, biosafety, and occupational health in dentistry. Additionally, in May 2017 the effectiveness of the instrument was documented within the dental care clinics in the postgraduate area. METHODS The instrument was developed based on constructs of occupational health, infection control, and biosafety in dentistry, made up of 21 indicators of 5 dimensions called protocols. Using direct observation through 35 measurements during 1 week, adherence to occupational health protocols was evaluated in postgraduate residents within the clinical sections of endodontics/pediatric dentistry, periodontics, prosthodontics, and orthodontics. RESULTS The instrument presents an index of 0.88 in Cronbach's alpha analysis. There is a 34.4% adherence within the postgraduate dental clinic to the proposed occupational health protocols. The protocol with the highest adherence at 41.1% was the personal protection protocol. The periodontics section had a 52.9% observance of the proposed protocols and had the highest adherence to occupational health protocols. CONCLUSIONS The proposed instrument is valid and reliable to evaluate adherence to the proposed occupational health protocols within dental care clinics. Dental clinics must be inspected and evaluated to ensure adherence to infection control, biosafety, and occupational health protocols within routine dental practice.
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Affiliation(s)
| | | | - Ramon A Monroy-Salcedo
- School of Dentistry, Universidad Autonoma de Guadalajara, Guadalajara, Jalisco, 44160, Mexico
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12
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Samur M, Seren Intepeler S, Lam SC. Adaptation and validation of the Compliance with Standard Precautions Scale amongst nurses in Turkey. Int J Nurs Pract 2020; 26:e12839. [PMID: 32304177 DOI: 10.1111/ijn.12839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 03/23/2020] [Accepted: 03/25/2020] [Indexed: 11/30/2022]
Abstract
AIMS To adapt and psychometrically test the Compliance with Standard Precautions Scale for use by Turkish nurses. BACKGROUND Measurement of standard precautions compliance is important to manage the safety of both patients and health care teams. METHODS This two-phase methodological study employed a correlational design with repeated measures. In phase one, the scale's adaptation, including translation, semantic equivalence, content and face validity, was implemented. In phase two, internal consistency and stability were used to examine the reliability of the scale. Construct validity was tested using the Rasch rating scale model. This study was conducted by recruiting 411 nurses from three different hospitals between September 2015 and September 2016. RESULTS Adaptation results showed that the Turkish version of the Compliance with Standard Precautions Scale (CSPS-T) is adequate for linguistic and content validation. The content validity index and comprehensibility of the scale were similarly satisfactory. The reliability of the CSPS-T was examined by Cronbach's alpha, corrected item-total correlations and intraclass correlation coefficient, and good results were obtained. The Rasch model showed that all items were compatible with the model. Whereas Item 4 was the most difficult, Item 10 was the easiest. CONCLUSION The CSPS-T is a reliable and valid tool for assessing compliance with standard precautions amongst Turkish nurses.
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Affiliation(s)
- Menevse Samur
- Nursing Management Department, Nursing Faculty, Dokuz Eylul University, Balcova, Izmir, Turkey
| | - Seyda Seren Intepeler
- Nursing Management Department, Nursing Faculty, Dokuz Eylul University, Balcova, Izmir, Turkey
| | - Simon Ching Lam
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
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Barratt R, Gilbert GL, Shaban RZ, Wyer M, Hor SY. Enablers of, and barriers to, optimal glove and mask use for routine care in the emergency department: an ethnographic study of Australian clinicians. Australas Emerg Care 2019; 23:105-113. [PMID: 31810897 PMCID: PMC7104090 DOI: 10.1016/j.auec.2019.10.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 09/30/2019] [Accepted: 10/04/2019] [Indexed: 12/27/2022]
Abstract
Background The risk of healthcare-acquired infection increases during outbreaks of novel infectious diseases. Emergency department (ED) clinicians are at high risk of exposure to both these and common communicable diseases. Personal protective equipment (PPE) is recommended to protect clinicians from acquiring, or becoming vectors of, infection, yet compliance is typically sub-optimal. Little is known about factors that influence use of PPE—specifically gloves and masks—during routine care in the ED. Methods This was an ethnographic study, incorporating documentation review, field observations and interviews. The theoretical domains framework (TDF) was used to aid thematic analysis and identify relevant enablers of and barriers to optimal PPE use. Results Thirty-one behavioural themes were identified that influenced participants’ use of masks and gloves. There were significant differences, namely: more reported enablers of glove use vs more barriers to mask use. Reasons included more positive unit culture towards glove use, and lower perception of risk via facial contamination. Conclusion Emerging infectious diseases, spread (among other routes) by respiratory droplets, have caused global outbreaks. Emergency clinicians should ensure that, as with gloves, the use of masks is incorporated into routine cares where appropriate. Further research which examines items of PPE independently is warranted.
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Affiliation(s)
- Ruth Barratt
- University of Sydney, Faculty of Medicine and Health, Westmead Hospital, Cnr Hawkesbury Road and, Darcy Rd, Westmead, NSW 2145, Australia.
| | - Gwendolyn L Gilbert
- University of Sydney, Faculty of Medicine and Health, Westmead Hospital, Cnr Hawkesbury Road and, Darcy Rd, Westmead, NSW 2145, Australia; University of Sydney, Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead Institute for Medical Research, 176 Hawkesbury Road, Westmead, NSW 2145, Australia; University of Sydney, Sydney Health Ethics, 92/94 Parramatta Rd, Camperdown, NSW, Australia
| | - Ramon Z Shaban
- University of Sydney, Faculty of Medicine and Health, Westmead Hospital, Cnr Hawkesbury Road and, Darcy Rd, Westmead, NSW 2145, Australia; University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Australia; University of Sydney, Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead Institute for Medical Research, 176 Hawkesbury Road, Westmead, NSW 2145, Australia; Nursing, Midwifery and Clinical Governance Directorate, Western Sydney Local Health District, Westmead Hospital, Cnr Hawkesbury Road and, Darcy Rd, Westmead, NSW 2145, Australia
| | - Mary Wyer
- University of Sydney, Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead Institute for Medical Research, 176 Hawkesbury Road, Westmead, NSW 2145, Australia; Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, 176 Hawkesbury Road, Westmead, NSW 2145, Australia; University of Sydney, Sydney Health Ethics, 92/94 Parramatta Rd, Camperdown, NSW, Australia
| | - Su-Yin Hor
- Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, 176 Hawkesbury Road, Westmead, NSW 2145, Australia; University of Sydney, Sydney Health Ethics, 92/94 Parramatta Rd, Camperdown, NSW, Australia; Centre for Health Services Management, Faculty of Health, University of Technology, Sydney, Australia
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Kim H, Hwang YH. Factors contributing to clinical nurse compliance with infection prevention and control practices: A cross-sectional study. Nurs Health Sci 2019; 22:126-133. [PMID: 31657511 DOI: 10.1111/nhs.12659] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 09/03/2019] [Accepted: 09/21/2019] [Indexed: 11/30/2022]
Abstract
Although healthcare-associated infection is preventable, low compliance with infection prevention and control practices has been a significant issue for hospitals. This study aimed to evaluate the knowledge, attitudes, perceived safe environment, and compliance of clinical nurses and to identify the factors contributing to compliance with infection prevention and control practices. A cross-sectional study was conducted with 197 nurses who worked in university hospitals in Korea. Data were collected using a self-administrated questionnaire. Nurses correctly answered 67.4% of the questions regarding infection prevention and control knowledge, with the lowest correct scores (55%) related to multidrug-resistant organisms. Nurses demonstrated favorable attitudes toward infection prevention and control (6.5 of 8) and favorable perceptions regarding safe environment (7.75 of 9). The overall compliance score was 87.41 of 100. Nurses' attitudes, perceived safe environment, and period of clinical experience had significant positive contributions to compliance. Among employment departments, the intensive care unit was associated with higher compliance. Our findings indicate that institutional support for safe environments should be combined with ongoing education for improving knowledge and attitudes of nurses, especially in general wards.
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Affiliation(s)
- Hyunjung Kim
- School of Nursing & Research Institute of Nursing Science, Hallym University, Chuncheon, Korea
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Knowledge, attitude, and practice of healthcare professionals regarding infection prevention at Gondar University referral hospital, northwest Ethiopia: a cross-sectional study. BMC Res Notes 2019; 12:563. [PMID: 31500659 PMCID: PMC6734428 DOI: 10.1186/s13104-019-4605-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 09/04/2019] [Indexed: 12/20/2022] Open
Abstract
Objectives Workplace health and safety is vital in every organization particularly in the healthcare settings. The aim was to assess the levels of knowledge, attitude, and practices of the healthcare professionals towards safety at Gondar University referral hospital. An institution based cross-sectional study was conducted from February to June 2018. Proportional random sampling technique was used to include 282 study participants and data were collected using a structured self-administered questionnaire and analyzed using SPSS version 20. Results Among 282 study participants, 230 (81.6%), 181 (64.2%), and 162 (57.4%) had adequate knowledge, favorable attitude, and adequate practice scores, respectively. More than half (55.3%) of the study participants were untrained. There was a high (26.6%) prevalence of needlestick injury; however, the use of post-exposure prophylaxis after potential exposures was very limited. Generally, the levels of knowledge, attitude, and practice scores among the study participants were low. Therefore, there should be adequate and consistent supply of personal protective devices and other materials used for infection prevention and control. In addition, there should be awareness raising mechanism, including the provision of job aids and periodic training. Further, comprehensive studies should be conducted by including different types and levels of health facilities.
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Sasaki JI, Imazato S. Autoclave sterilization of dental handpieces: A literature review. J Prosthodont Res 2019; 64:239-242. [PMID: 31416709 DOI: 10.1016/j.jpor.2019.07.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 07/20/2019] [Accepted: 07/26/2019] [Indexed: 11/17/2022]
Abstract
PURPOSE The present review aimed to investigate autoclave sterilization of dental handpieces based on available studies. STUDY SELECTION The sterilizing efficiency of dental handpieces with autoclave is mainly affected by the types of apparatus (N, B, and S), the packaging with sterilizing pouch, cleaning, and lubrication. These subjects were reviewed based on the in vitro experimental studies. RESULTS Dental handpieces can be sterilized, including inactivation of heat-resistant bacterial spores, with type B or type S sterilizers, regardless of the use of a sterilization pouch. In contrast, although type N autoclaves are capable of sterilization of general bacteria such as Streptococcus salivarius even in a sterilization pouch if instruments are washed beforehand, complete sterilization of the wrapped handpiece is not always achieved. Therefore, to achieve sterilization efficiency with type N autoclaves, processing without any packaging is recommended. As regards cleaning of handpiece, although contamination decreases with irrigation and wiping of handpieces, all reports concluded that these treatments alone do not achieve complete decontamination of reusable handpieces. CONCLUSION Although type B and type S autoclaves allow us to sterilize the dental handpieces, it is important to realize that complete sterilization of the handpiece is not always achieved by type N autoclave. Understanding autoclave processing of handpieces is essential for dental practice to deliver the safe dental care.
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Affiliation(s)
- Jun-Ichi Sasaki
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Japan
| | - Satoshi Imazato
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Japan.
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Interprofessional perceptions and emotional impact of multidrug-resistant organisms: A qualitative study. Am J Infect Control 2019; 47:876-882. [PMID: 30850246 DOI: 10.1016/j.ajic.2019.01.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 01/25/2019] [Accepted: 01/25/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Hospital-acquired infections caused by multidrug-resistant organisms (MDROs) are a threat to patient safety and hospital economy. Training in hygiene precautions is known to limit MDRO spread and patient morbidity. As infection prevention is a collaborative task, we developed an interprofessional educational intervention, including a reflective unit about MDRO. This article reports on the perceptions of professionals for MDRO management. METHODS In 2017, we conducted 8 trainings, including facilitated group discussions focusing on the question how participants think others experience MDRO. Results were analyzed using a socio-constructivist qualitative approach. RESULTS A total of 51 health care workers from 13 professions and 5 hospitals participated, generating 366 items for coding. Three main themes could be identified: (1) significant barriers in educating clinicians and informing lay persons, (2) emotional reactions-especially anxiety and anger-from the perspective of lay persons and professionals evoked by MDRO, and (3) perceived economic burden. CONCLUSIONS MDROs generate psychosocial side effects with an impact on health care management and on professional-patient relationships and interprofessional relationships. Specifically, emotions evoked by insufficient information and transparency play a major role. Therefore, hygiene trainings must not be limited to basic skills. In addition, they should be comprised of communication and educational techniques and evoke attentiveness for emotional stress.
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Donati D, Biagioli V, Cianfrocca C, Marano T, Tartaglini D, De Marinis MG. Experiences of compliance with standard precautions during emergencies: A qualitative study of nurses working in intensive care units. Appl Nurs Res 2019; 49:35-40. [PMID: 31495417 DOI: 10.1016/j.apnr.2019.07.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 06/17/2019] [Accepted: 07/27/2019] [Indexed: 01/05/2023]
Abstract
Aim To explore factors that influence intensive care nurses' experiences of being compliant with standard precautions (SP) during emergencies. BACKGROUND Intensive care nurses can be exposed to a greater risk of biohazardous exposure during an emergency. The primary strategy to address the complex variety of biological hazards in clinical practice is represented by the implementation of SP guidelines. Previous research has indicated that nurses' compliance rates with SPs are suboptimal, but no study has focused on the factors influencing compliance during an emergency. DESIGN A descriptive qualitative study was conducted in an Italian university hospital with 19 intensive care nurses who had at least two years of work experience in critical care. The nurses were interviewed in four focus groups and were asked about their experiences of being compliant with SPs during an emergency. Data were analyzed using conventional content analysis. RESULTS Three themes emerged: conflict, competencies, and context. Conflict was reported regarding the need to save the patient and the need for self-protection through the use of SPs. In particular, nurses had to manage the pressure of limited time. Competencies were identified by nurses' knowledge, attitude, skills, training, and experience. Context was related to the work and organizational conditions during the emergency, including overcrowding. CONCLUSION To support intensive care nurses' compliance with SPs during emergencies, conflict, competencies, and context should be audited regularly in clinical practice. The findings of this study could inform infection control programs and training that targets intensive care nurses.
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Affiliation(s)
- Daniele Donati
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, via Montpellier 1, 00133 Rome, Italy.
| | - Valentina Biagioli
- Research Unit Nursing Science, Campus Bio-Medico University of Rome, via Álvaro del Portillo 21, 00128 Rome, Italy.
| | - Claudia Cianfrocca
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, via Montpellier 1, 00133 Rome, Italy.
| | - Tiziana Marano
- Research Unit Nursing Science, Campus Bio-Medico University of Rome, via Álvaro del Portillo 21, 00128 Rome, Italy.
| | - Daniela Tartaglini
- Research Unit Nursing Science, Campus Bio-Medico University of Rome, via Álvaro del Portillo 21, 00128 Rome, Italy.
| | - Maria Grazia De Marinis
- Research Unit Nursing Science, Campus Bio-Medico University of Rome, via Álvaro del Portillo 21, 00128 Rome, Italy.
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Bouchoucha SL, Moore KA. Factors Influencing Adherence to Standard Precautions Scale: A psychometric validation. Nurs Health Sci 2019; 21:178-185. [PMID: 30362238 PMCID: PMC7159402 DOI: 10.1111/nhs.12578] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 07/20/2018] [Accepted: 09/06/2018] [Indexed: 12/17/2022]
Abstract
Despite the mandated use of standard precaution guidelines to limit infection transmission in health-care settings, adherence by health-care professionals is suboptimal. There is currently no psychometrically-validated scale to assess influences on workers' adherence. After the data collection was conducted, Michinov et al. (2016) published a questionnaire to determine sociocognitive determinants of adherence to Standard Precautions. The aim of the present study was to develop and test the psychometric properties of such a scale. Forty nine items were derived from interviews with 29 nurses and tested across two studies. Study 1 was a repeated-measures survey using principal components analysis with data from 363 participants; a 29 item, five factor solution was extracted with good to acceptable internal reliabilities (α = .61-.85). Data from 122 of the original participants retested at 4 weeks showed intraclass correlations of .69-.84. Study 2, which was 6 months later, used confirmatory factor analysis with data from a second sample of 384 participants, and supported the five factor structure of leadership, justification, culture/practice, contextual cues, and judgement. The Factors Influencing Adherence to Standard Precautions Scale has good psychometric properties and stability across time and samples. The scale is suitable for use with nurses, and its validation with other health-care professionals and trainees is important in order to tailor effective interventions to promote adherence.
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Affiliation(s)
- Stéphane L. Bouchoucha
- Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Deakin UniversityGeelongVictoriaAustralia
| | - Kathleen A. Moore
- School of Health and Life Sciences, Federation UniversityChurchillVictoriaAustralia
- School of Psychology, Charles Sturt UniversityBathurstAustralia
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Kelcikova S, Mazuchova L, Bielena L, Filova L. Flawed self-assessment in hand hygiene: A major contributor to infections in clinical practice? J Clin Nurs 2019; 28:2265-2275. [PMID: 30786083 DOI: 10.1111/jocn.14823] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 02/04/2019] [Accepted: 02/09/2019] [Indexed: 12/27/2022]
Abstract
AIM To assess the quality of self-assessment and the attitude of healthcare workers (HCWs) to hand hygiene (HH) as possible factors of unsatisfactory HH compliance in clinical practice. BACKGROUND Noncompliance of HH causes healthcare-acquired infections (HAI) in patients. It is assumed that HH-related infections make up approximately 80% of all infections in clinical practice. Our observations suggest that self-assessment and attitude might be surprisingly important factors. DESIGN AND METHOD The cross-sectional approach using questionnaire and direct observation was applied. We followed STROBE guidelines. In total, questionnaires of 639 HCWs of surgical departments were included in the study, and 127 HCWs had been also directly observed. RESULTS High self-assessment regarding HH compliance and its knowledge was reported by 74% and 83% of HCWs, respectively. At the same time, only 51% of HCWs positively evaluated their colleagues with respect to HH. Similar to previous studies, we have found significant differences between physicians and nurses regarding the level of self-assessment, attitude and perception of HH. Physicians were more critical in self-assessment and considered HH less important compared to nurses. The observations revealed drawbacks in HH practices. The high level of self-overassessment might be a contributing factor to noncompliance with HH. CONCLUSIONS It is necessary to establish systematic professional training and education of HCWs in relation to their HH, and to continuously monitor and evaluate the level of self-assessment in clinical practice, mainly in surgery. RELEVANCE TO CLINICAL PRACTICE A reasonable objective level of self-assessment and attitude to HH are the most important conditions for preventing of HAI in patients.
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Affiliation(s)
- Simona Kelcikova
- Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Bratislava, Slovak
| | - Lucia Mazuchova
- Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Bratislava, Slovak
| | - Lubica Bielena
- Martin University Hospital, Department of Hospital Hygiene, Martin, Slovak
| | - Lenka Filova
- Faculty of Mathematics, Physics and Informatics, Comenius University in Bratislava, Bratislava, Slovak
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Donati D, Biagioli V, Cianfrocca C, De Marinis MG, Tartaglini D. Compliance with Standard Precautions among Clinical Nurses: Validity and Reliability of the Italian Version of the Compliance with Standard Precautions Scale (CSPS-It). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16010121. [PMID: 30621210 PMCID: PMC6339176 DOI: 10.3390/ijerph16010121] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 12/19/2018] [Accepted: 12/28/2018] [Indexed: 01/22/2023]
Abstract
Background: The compliance with Standard Precautions (SPs) guidelines, as a primary strategy for the prevention of healthcare associated infections, is still suboptimal among healthcare providers. However, no instrument measuring nurses’ compliance with SPs is available in Italian. This study aims to assess the validity and reliability of the Compliance with Standard Precaution Scale–Italian version (CSPS-It) among clinical nurses. Methods: The study consisted of two phases: (1) translation and cross-cultural adaptation of the CSPS; (2) validity and reliability evaluation of the CSPS-It. Confirmatory factor analysis (CFA) and hypothesis testing were performed to evaluate the construct validity. Cronbach’s alpha, intra-class correlation coefficient of test-retest scores, and item-total correlations were computed to establish reliability. Results: The CSPS-It showed a sound validity and reliability. The unidimensional model tested at CFA yielded acceptable fit indices. The hypothesis testing supported better nurses’ compliance based on participation in at least one training course on SPs. Conclusions: The CSPS-It is a valid and reliable instrument for measuring the compliance with SPs among clinical nurses. This version will allow for the conduction of further studies in favor of progress in this specific field of research. Managers should pay greater attention in monitoring compliance with SPs among clinical nurses.
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Affiliation(s)
- Daniele Donati
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, 00133 Rome, Italy.
| | - Valentina Biagioli
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, 00133 Rome, Italy.
| | - Claudia Cianfrocca
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, 00133 Rome, Italy.
| | | | - Daniela Tartaglini
- Research Unit Nursing Science, Campus Bio-Medico University of Rome, 00128 Rome, Italy.
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Korhonen A, Vuori A, Lukkari A, Laitinen A, Perälä M, Koskela T, Pölkki T. Increasing nursing students' knowledge of evidence-based hand-hygiene: A quasi-experimental study. Nurse Educ Pract 2019; 35:104-110. [PMID: 30772734 DOI: 10.1016/j.nepr.2018.12.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 11/13/2018] [Accepted: 12/29/2018] [Indexed: 01/26/2023]
Abstract
Aim of study was to evaluate the effects of a multi-component intervention on nursing students' knowledge of evidence-based hand-hygiene. A quasi-experimental design was used. Nursing students (N = 146) from two universities of applied sciences (experimental group n = 107, control group n = 39) completed an instrument based on international clinical guidelines related to hand hygiene that consisted of 17 Likert-scale items. Data were collected at three time points (baseline, after university-based training and after clinical training) between autumn 2014 and spring 2016. Group differences were examined using chi-squared or Fisher Exact tests, the Mann-Whitney and U test. Within-group differences were assessed with the McNemar test for paired nominal data. At the first and second time points the experimental group had better hand hygiene knowledge than the controls. There were no group differences in responses to items concerning the appropriate length of hand disinfection. The experimental group showed improvements in the practice of washing hands with soap and water, but not in the other statements concerning hand disinfection. Theoretical recap and training at school seemed to influence students' hand hygiene knowledge, but reinforcement during clinical training may be required to ensure that learning practical evidence-based skills, such as hand-hygiene, may be established.
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Affiliation(s)
| | - Anne Vuori
- Lahti University of Applied Sciences, Faculty of Social and Health Care, Hoitajankatu 3, FI-15850, Lahti, Finland.
| | - Anne Lukkari
- Department of Children and Women, Oulu University Hospital, Finland.
| | - Arja Laitinen
- Department of Children and Women, Oulu University Hospital, Finland.
| | - Minna Perälä
- Oulu University of Applied Sciences, School of Health and Social Care, Finland.
| | - Terttu Koskela
- Oulu University of Applied Sciences, School of Health and Social Care, Finland.
| | - Tarja Pölkki
- Department of Children and Women, Oulu University Hospital, Finland.
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Russell D, Dowding DW, McDonald MV, Adams V, Rosati RJ, Larson EL, Shang J. Factors for compliance with infection control practices in home healthcare: findings from a survey of nurses' knowledge and attitudes toward infection control. Am J Infect Control 2018; 46:1211-1217. [PMID: 29866633 DOI: 10.1016/j.ajic.2018.05.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 04/03/2018] [Accepted: 05/03/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Infection is a leading cause of hospitalization among home healthcare patients. Nurses play an important role in reducing infection among home healthcare patients by complying with infection control procedures. However, few studies have examined the compliance of home healthcare nurses with infection control practices or the range of sociocultural and organizational factors that may be associated with compliance. METHODS This study analyzed survey responses from nurses at 2 large, certified home healthcare agencies (n = 359), to explore levels of compliance with infection control practices and identify associated demographic, knowledge, and attitudinal correlates. RESULTS Nurses reported a high level of infection control compliance (mean = 0.89, standard deviation [SD] = 0.16), correct knowledge (mean = 0.85, SD = 0.09), and favorable attitudes (mean = 0.81, SD = 0.14). Multivariate mixed regression analyses revealed significant positive associations of attitudinal scores with reported level of compliance (P < .001). However, knowledge of inflection control practices was not associated with compliance. Older (P < .05) and non-Hispanic black (P < .001) nurses reported higher compliance with infection control practices than younger and white non-Hispanic nurses. CONCLUSION These findings suggest that efforts to improve compliance with infection control practices in home healthcare should focus on strategies to alter perceptions about infection risk and other attitudinal factors.
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Affiliation(s)
- David Russell
- Department of Sociology, Appalachian State University, Boone, NC; Center for Home Care Policy & Research, Visiting Nurse Service of New York, New York, NY.
| | - Dawn W Dowding
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Margaret V McDonald
- Center for Home Care Policy & Research, Visiting Nurse Service of New York, New York, NY
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Fogel I, David O, Balik CH, Eisenkraft A, Poles L, Shental O, Kassirer M, Brosh-Nissimov T. The association between self-perceived proficiency of personal protective equipment and objective performance: An observational study during a bioterrorism simulation drill. Am J Infect Control 2017; 45:1238-1242. [PMID: 28673681 PMCID: PMC7132699 DOI: 10.1016/j.ajic.2017.05.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 05/25/2017] [Accepted: 05/25/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND The recent Ebola virus disease outbreak emphasized the potential misuse of personal protective equipment (PPE) by health care workers (HCWs) during such an event. We aimed to compare self-perceived proficiency of PPE use and objective performance, and identify predictors of low compliance and PPE misuse. METHODS An observational study combined with subjective questionnaires were carried out during a bioterror simulation drill. Forty-two observers evaluated performance under PPE. Mistakes were recorded and graded using a structured observational format and were correlated with the subjective questionnaires and with demographic parameters. RESULTS One hundred seventy-eight HCWs from community clinics and hospitals were included. The mean self-perceived proficiency was high (6.1 out of 7), mean level of comfort was moderate (4.0 out of 7), and mean objective performance was intermediate (9.5 out of 13). There was no correlation between comfort and objective performance scores. Self-perceived proficiency was in correlation with donning and continuous performance with PPE but not with doffing. Clinic personnel performed better than personnel in hospitals (40.3% vs 67.8% with 3 or more mistakes, respectively; P = .001). Demographic characteristics had no correlation with objective or self-perceived performance. CONCLUSIONS Self-perceived proficiency is a poor predictor of appropriate PPE use. The results suggest poor awareness of the possibility of PPE misuse.
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Strengthening Human Immunodeficiency Virus and Tuberculosis Prevention Capacity among South African Healthcare Workers: A Mixed Methods Study of a Collaborative Occupational Health Program. Saf Health Work 2017; 9:172-179. [PMID: 29928531 PMCID: PMC6005912 DOI: 10.1016/j.shaw.2017.08.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 06/26/2017] [Accepted: 08/15/2017] [Indexed: 12/16/2022] Open
Abstract
Background Insufficient training in infection control and occupational health among healthcare workers (HCWs) in countries with high human immunodeficiency virus (HIV) and tuberculosis (TB) burdens requires attention. We examined the effectiveness of a 1-year Certificate Program in Occupational Health and Infection Control conducted in Free State Province, South Africa in an international partnership to empower HCWs to become change agents to promote workplace-based HIV and TB prevention. Methods Questionnaires assessing reactions to the program and Knowledge, Attitudes, Skills, and Practices were collected pre-, mid-, and postprogram. Individual interviews, group project evaluations, and participant observation were also conducted. Quantitative data were analyzed using Wilcoxon signed-rank test. Qualitative data were thematically coded and analyzed using the Kirkpatrick framework. Results Participants recruited (n = 32) were mostly female (81%) and nurses (56%). Pre-to-post-program mean scores improved in knowledge (+12%, p = 0.002) and skills/practices (+14%, p = 0.002). Pre-program attitude scores were high but did not change. Participants felt empowered and demonstrated attitudinal improvements regarding HIV, TB, infection control, and occupational health. Successful projects were indeed implemented. However, participants encountered considerable difficulties in trying to sustain improvement, due largely to lack of pre-existing knowledge and experience, combined with inadequate staffing and insufficient management support. Conclusion Training is essential to strengthen HCWs' occupational health and infection control knowledge, attitudes, skills, and practices, and workplace-based training programs such as this can yield impressive results. However, the considerable mentorship resources required for such programs and the substantial infrastructural supports needed for implementation and sustainability of improvements in settings without pre-existing experience in such endeavors should not be underestimated.
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Lin YS, Lin YC, Lou MF. Concept analysis of safety climate in healthcare providers. J Clin Nurs 2017; 26:1737-1747. [PMID: 27862495 DOI: 10.1111/jocn.13641] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2016] [Indexed: 12/12/2022]
Abstract
AIM AND OBJECTIVE To report an analysis of the concept of safety climate in healthcare providers. BACKGROUND Compliance with safe work practices is essential to patient safety and care outcomes. Analysing the concept of safety climate from the perspective of healthcare providers could improve understanding of the correlations between safety climate and healthcare provider compliance with safe work practices, thus enhancing quality of patient care. DESIGN Concept analysis. DATA SOURCES The electronic databases of CINAHL, MEDLINE, PubMed and Web of Science were searched for literature published between 1995-2015. Searches used the keywords 'safety climate' or 'safety culture' with 'hospital' or 'healthcare'. METHOD The concept analysis method of Walker and Avant analysed safety climate from the perspective of healthcare providers. RESULTS Three attributes defined how healthcare providers define safety climate: (1) creation of safe working environment by senior management in healthcare organisations; (2) shared perception of healthcare providers about safety of their work environment; and (3) the effective dissemination of safety information. Antecedents included the characteristics of healthcare providers and healthcare organisations as a whole, and the types of work in which they are engaged. Consequences consisted of safety performance and safety outcomes. Most studies developed and assessed the survey tools of safety climate or safety culture, with a minority consisting of interventional measures for improving safety climate. CONCLUSION More prospective studies are needed to create interventional measures for improving safety climate of healthcare providers. This study is provided as a reference for use in developing multidimensional safety climate assessment tools and interventional measures. RELEVANCE TO CLINICAL PRACTICE The values healthcare teams emphasise with regard to safety can serve to improve safety performance. Having an understanding of the concept of and interventional measures for safety climate allows healthcare providers to ensure the safety of their operations and their patients.
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Affiliation(s)
- Ying-Siou Lin
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Yen-Chun Lin
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Meei-Fang Lou
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
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Pereira FMV, Lam SC, Gir E. Cultural Adaptation and Reliability of the Compliance with Standard Precautions Scale (CSPS) for Nurses in Brazil. Rev Lat Am Enfermagem 2017; 25:e2850. [PMID: 28301030 PMCID: PMC5363326 DOI: 10.1590/1518-8345.1204.2850] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 10/26/2016] [Indexed: 11/30/2022] Open
Abstract
Objective: this study aimed to carry of the cultural adaptation and to evaluate the reliability of the Compliance with Standard Precautions Scale (CSPS) for nurses in Brazil. Method: the adaptation process entailed translation, consensus among judges, back-translation, semantic validation and pretest. The reliability was evaluated by internal consistency (Cronbach alpha) and stability (test-retest). The instrument was administered to a sample group of 300 nurses who worked in a large hospital located in the city of São Paulo/SP, Brazil. Results: through the semantic validation, the items from the scale were considered understandable and deemed important for the nurse´s clinical practice. The CSPS Brazilian Portuguese version (CSPS-PB) revealed excellent interpretability. The Cronbach`s alpha was 0.61 and the intraclass correlation coefficient was 0.85. Conclusion: the initial study showed that CSPS-PB is appropriate to assess compliance with standard precautions among nurses in Brazil. The reliability was considered acceptable. Furhter study is necessary to evaluate its comprehensive psychometric properties.
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Affiliation(s)
| | - Simon Ching Lam
- PhD, Associate Professor, Division of Nursing and Health Studies, The Open University of Hong Kong, Hong Kong, China
| | - Elucir Gir
- PhD, Full Professor, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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Hessels AJ, Genovese-Schek V, Agarwal M, Wurmser T, Larson EL. Relationship between patient safety climate and adherence to standard precautions. Am J Infect Control 2016; 44:1128-1132. [PMID: 27318523 DOI: 10.1016/j.ajic.2016.03.060] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 03/12/2016] [Accepted: 03/14/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND Standard precautions (SPs) are designed to limit bloodborne pathogen exposures among health care workers (HCWs) and health care-associated infections. SP adherence is globally suboptimal; however, reasons are underexplored. This study aim was to explore the relationships among safety climate factors and SP adherence by HCWs in hospitals using newly developed survey and observational tools. METHODS Cross-sectional data from 11 units in 5 hospitals were collected between March and September 2015. A patient safety and standard precaution survey was administered to nurses and pooled with data from observations of HCW-patient interactions using defined SP indications. Descriptive statistics of distributions, frequencies, and Pearson correlation coefficients were calculated to determine the unit-level relationships among dimensions of the patient safety climate and unit percentages of SP adherence (P < .05). RESULTS There were 540 HCW-patient encounters with 1,713 SP indications and 140 surveys collected. Although most nurses (94%) reported always or often adhering to SPs and generally reported positive scores on unit safety climate, observed SP adherence was 62% (unit range, 31%-80%). Only 30% of nurses rated staffing positively, and this was inversely related to observed SP adherence. CONCLUSIONS Adherence to the full complement of observed SP behaviors by HCWs of all types was suboptimal. The relationship between safety climate, particularly staffing, and adherence to SPs warrants further testing.
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Zimmerman PA, Mason M, Elder E. A healthy degree of suspicion: A discussion of the implementation of transmission based precautions in the emergency department. ACTA ACUST UNITED AC 2016; 19:149-52. [PMID: 27133874 PMCID: PMC7128487 DOI: 10.1016/j.aenj.2016.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 03/10/2016] [Accepted: 03/29/2016] [Indexed: 02/01/2023]
Abstract
Background Emergency department (ED) presentations have increased significantly domestically and internationally. Swift identification and implementation of transmission based precautions (TBP) for patients known or suspected of having an epidemiologically important pathogen is important. ED staff, particularly triage nurses, are pivotal in detecting and preventing infection, including healthcare associated infections (HAI). Methods MEDLINE, CINAHL, PubMed and Ovid were searched for articles published between 2004 and 2015 using key search terms: infection control/prevention and emergency department(s), triage, and transmission based precautions and emergency department(s), and triage, to identify common themes for discussion. Systematic review/meta-analysis was not in the scope of this exploration. Findings Themes were identified relating to HAI and ED practices and grouped into: assisted detection of conditions for which TBP is required, ED and TBP, mass-causality event/bioterrorism/pandemic/epidemic, infection control not TBP and multi-resistant organisms not TBP. The literature is heavily influenced by worldwide epidemic/pandemics and bioterrorist risks resulting in increased awareness of the importance of swift identification of syndromes that require TBP, but only in these situations. Conclusion Implementation of appropriate TBP, changing triage practices, training and measures to assist decision-making could assist in preventing HAI in the ED context. A systematic quantitative review of the literature is recommended to guide practice change research.
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Affiliation(s)
- Peta-Anne Zimmerman
- School of Nursing and Midwifery, Griffith University, Australia; Gold Coast Hospital and Health Service, Australia.
| | - Matt Mason
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Australia
| | - Elizabeth Elder
- School of Nursing and Midwifery, Griffith University, Australia
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White KM, Starfelt LC, Jimmieson NL, Campbell M, Graves N, Barnett AG, Cockshaw W, Gee P, Page K, Martin E, Brain D, Paterson D. Understanding the determinants of Australian hospital nurses' hand hygiene decisions following the implementation of a national hand hygiene initiative. HEALTH EDUCATION RESEARCH 2015; 30:959-970. [PMID: 26590244 DOI: 10.1093/her/cyv057] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Hand hygiene is the primary measure in hospitals to reduce the spread of infections, with nurses experiencing the greatest frequency of patient contact. The '5 critical moments' of hand hygiene initiative has been implemented in hospitals across Australia, accompanied by awareness-raising, staff training and auditing. The aim of this study was to understand the determinants of nurses' hand hygiene decisions, using an extension of a common health decision-making model, the theory of planned behaviour (TPB), to inform future health education strategies to increase compliance. Nurses from 50 Australian hospitals (n = 2378) completed standard TPB measures (attitude, subjective norm, perceived behavioural control [PBC], intention) and the extended variables of group norm, risk perceptions (susceptibility, severity) and knowledge (subjective, objective) at Time 1, while a sub-sample (n = 797) reported their hand hygiene behaviour 2 weeks later. Regression analyses identified subjective norm, PBC, group norm, subjective knowledge and risk susceptibility as the significant predictors of nurses' hand hygiene intentions, with intention and PBC predicting their compliance behaviour. Rather than targeting attitudes which are already very favourable among nurses, health education strategies should focus on normative influences and perceptions of control and risk in efforts to encourage hand hygiene adherence.
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Affiliation(s)
- Katherine M White
- School of Psychology and Counselling, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane 4059, Australia, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane 4059, Australia,
| | - Louise C Starfelt
- School of Psychology and Counselling, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane 4059, Australia
| | - Nerina L Jimmieson
- School of Management, Queensland University of Technology, 2 George Street, Brisbane 4000, Australia
| | - Megan Campbell
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane 4059, Australia
| | - Nicholas Graves
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane 4059, Australia
| | - Adrian G Barnett
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane 4059, Australia
| | - Wendell Cockshaw
- School of Psychology and Counselling, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane 4059, Australia, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane 4059, Australia
| | - Phillip Gee
- School of Psychology, The University of Queensland, Sir Fred Schonell Drive, St Lucia, Brisbane, 4072, Australia
| | - Katie Page
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane 4059, Australia
| | - Elizabeth Martin
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane 4059, Australia
| | - David Brain
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane 4059, Australia
| | - David Paterson
- The University of Queensland Centre for Clinical Research, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Brisbane 4029, Australia
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Korhonen A, Ojanperä H, Puhto T, Järvinen R, Kejonen P, Holopainen A. Adherence to hand hygiene guidelines - significance of measuring fidelity. J Clin Nurs 2015; 24:3197-205. [DOI: 10.1111/jocn.12969] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2015] [Indexed: 11/27/2022]
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Jansen AC, Marziale MHP, Santos CBD, Dantas RAS, Ko NY. ASSESSMENT OF ADHERENCE TO POST-EXPOSURE CONDUCTS AMONG HEALTH WORKERS: TRANSLATION AND CULTURAL ADAPTATION OF AN INSTRUMENT. TEXTO & CONTEXTO ENFERMAGEM 2015. [DOI: 10.1590/0104-07072015011010014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
ABSTRACTMethodological study, undertaken between July/2011 and June/2012, whose aim was to translate and culturally adapt to Brazil the Chinese instrument (健康照顧專業人員職業性危害針扎後之追蹤) that assesses health professionals' intent to comply with conducts post-occupational exposure to biological material. The sample was random and consisted of 15 nursing professionals, exposed to biological material. The cross-cultural adaptation process showed to be satisfactory and the semantic validation evidenced that the instrument is understandable (73.3%), appropriate for the Brazilian culture and well accepted (85.2% of the items with favorable answers). The use of this instrument in Brazilian studies will permit broader discussions about actions to prevent occupational exposure to biological material and the planning of new strategies for the health services.
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De Carli G, Abiteboul D, Puro V. The importance of implementing safe sharps practices in the laboratory setting in Europe. Biochem Med (Zagreb) 2014; 24:45-56. [PMID: 24627714 PMCID: PMC3936965 DOI: 10.11613/bm.2014.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 01/03/2014] [Indexed: 12/27/2022] Open
Abstract
Healthcare workers are at risk of sharps injuries and subsequent infection from more than 40 bloodborne pathogens or species. Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) together account for the vast majority of cases. The Directive 2010/32/EU “Prevention from sharp injuries in the hospital and healthcare sector”, issued to protect workers from these risks, requires an integrated approach to prevention including awareness-raising, education, training, elimination of unnecessary needles, safe procedures for sharps use and disposal, banning of recapping, vaccination, use of personal protective equipment, provision of safety-engineered devices, and appropriate surveillance, monitoring, response and follow-up. As laboratories represent a high-risk setting both in the preanalytical and analytical phase, we reviewed accidents and prevention in this setting in the light of the new legislation. Phlebotomy is the procedure carrying the highest risk of exposure and infection, involved in 30–50% of HIV and HCV cases detected in nationwide systems following accidental blood exposures implemented since the 1990s in Italy and France. In laboratories, problems in the management of sharps containers, recapping, needle disassembly by hand and blood transfer from syringes into tubes were observed and accounted for two-thirds of injuries. These accidents could be reduced through education and monitoring of behaviours, and introduction of medical devices incorporating safety-engineered protection mechanisms with appropriate training. Laboratory staff should be immunized against HBV, and know policies and procedures for the post-exposure management and prophylaxis. The management commitment to safety is crucial to ensure the necessary support to these changes.
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Affiliation(s)
- Gabriella De Carli
- Infezioni Emergenti e Riemergenti e Centro di Riferimento AIDS, Department of Epidemiology and Pre-Clinical Research, National Institute for Infectious Diseases L. Spallanzani IRCCS, Rome, Italy
| | - Dominique Abiteboul
- Groupe d'Etude sur le Risque d'Exposition au Sang (GERES), Université Paris Diderot, Hôpital Bichat-Claude Bernard, Paris, France
| | - Vincenzo Puro
- Infezioni Emergenti e Riemergenti e Centro di Riferimento AIDS, Department of Epidemiology and Pre-Clinical Research, National Institute for Infectious Diseases L. Spallanzani IRCCS, Rome, Italy
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