Infection control professionals play several important roles--surveyors, educators, and ultimately change agents--in the identification and prevention of nosocomial infections in hospitals. The medical and surgical intensive care units (ICUs) in a large inner-city teaching hospital experienced an increased patient colonization rate with vancomycin-resistant enterococcus (VRE). Intervening in this problem required a multifaceted approach to control the spread of VRE and to change behavior by shifting social norms at multiple levels throughout the ICU community. The success of the interventions could be best explained by applying the use of several behavioral science models. The Ecological Model of Behavior Change, the Health Belief Model, and Social Cognitive Theory can be applied and are consistent with the successful interventions. This multifaceted approach to intervening in this problem consists of five levels of influence: (1) intrapersonal or individual factors, (2) interpersonal factors, (3) institutional factors, (4) community factors, and (5) public factors. We implemented educational inservices and developed references, policies, and programs directed at each of the five levels of influence. The Health Belief Model and Social Cognitive Theory were employed for intervention, and behavior change was based on modeling, observational learning, and vicarious reinforcement. Within six months of initial implementation, the number of positive VRE surveillance cultures and positive clinical isolates decreased significantly in both the medical and surgical ICUs. Two years later, there continues to be a marked reduction of VRE.
OBJECTIVE:
This study was conducted to evaluate the responses of 3,265 health professionals who took a continuing education (CE) activity during June 2009 - April 2012 for a comprehensive set of good laboratory practice recommendations for molecular genetic testing.
DESIGN:
Participants completed an evaluation questionnaire as part of the CE activity. Responses were summarized to assess the participants’ learning outcomes and commitment to applying the knowledge gained.
PARTICIPANTS:
Participants included nurses (47%), laboratory professionals (18%), physicians (14%), health educators (4%), public health professionals (2%), office staff (1%), and other health professionals (10%).
RESULTS:
Only 32% of all participants correctly answered all 12 open-book knowledge-check questions, ranging from 4 to 42% among the different professional groups (P<0.0001). However, over 80% of all participants expressed confidence in describing the practice recommendations, and 75% indicated the recommendations would improve the quality of their practice. Developing health education materials and local practice guidelines represented the common areas in which participants planned to use the knowledge gained (49% and 18% of all participants, respectively).
CONCLUSION:
Despite perceived self-efficacy in most participants, as high as 68% did not fully use the learning materials provided to answer the knowledge-check questions. These findings suggest the need for improved CE activities that motivate effective learning and address the specific needs of different health professions.
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