Barriers and enablers to meticillin-resistant Staphylococcus aureus admission screening in hospitals: a mixed-methods study

Currie, Kay; King, Carole; McAloney‐Kocaman, Kareena; Roberts, Nicola; MacDonald, Jennifer; Dickson, Adele; Cairns, Shona; Khanna, Nitish; Flowers, Paul; Reilly, Jacqui; Price, Lesley

doi:10.1016/j.jhin.2018.08.006

Cited by 9 publications

(17 citation statements)

References 23 publications

(20 reference statements)

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“…Also, to guarantee sufficient knowledge is present within an institution at all times, we suggest to appoint one or several designated individuals within healthcare institutions that possess knowledge on CPE/CRA and who actively inform others within the institution in case of CPE/CRA-positive patients. Our findings on the importance of adequate knowledge and perceived severity among healthcare providers correlate with findings from a study exploring barriers and enablers to MRSA admission screening in hospitals [36] and a study into the acceptability of screening for CPE [37].…”

Section: Discussionsupporting

confidence: 76%

Perceived barriers and enablers for preventing the spread of carbapenem producing gram-negative bacteria during patient transfers: a mixed methods study among healthcare providers

et al. 2019

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BackgroundAntimicrobial resistance (AMR) increasingly threatens public health. Carbapenem-producing gram-negative bacteria (CPB) pose the biggest threat. The risk for CPB spread is heightened during the transfer of a CPB-positive patient between different healthcare institutions or healthcare providers. We aimed to gain insight into the frequency of CPB-positive patients in the Dutch provinces of Noord-Holland (NH) and Flevoland (FL). Secondly, we aimed to obtain a deeper understanding of the communication between healthcare providers during transfers of CPB-positive patients and explore possible communication-related risk situations for CPB spread.MethodsThis mixed-methods study consisted of a quantitative and qualitative section. For the quantitative section, 14 laboratories that provide diagnostics in NH and FL voluntarily reported carbapenem-producing Enterobacteriaceae (CPE) positive patients between February 2018 and February 2019. Additionally, two laboratories reported carbapenem-resistant Acinetobacter spp. (CRA) and carbapenem-resistant Pseudomonas aeruginosa (CRP) positive patients. For the qualitative section, healthcare providers of reported patients were interviewed about information exchange during patient transfers, precautionary measures and knowledge and beliefs concerning CPB.ResultsIn total, 50 CPE-positive, 10 CRA-positive and 4 CRP-positive patients were reported during the inclusion period. Eighteen index-specific and 2 general interviews were conducted with 20 different care providers of 9 patients. The interviews revealed that, in most cases, information concerning the patient was transferred timely, but often a standardized method for sharing the information within and between institutions was lacking. Factors that enhanced care providers’ motivation to adhere to precautionary measures were taking responsibility for the health of other patients, (pregnant) colleagues and for ones own health. Factors that reduced motivation were not acknowledging the relevance of the precautionary measures, a perceived negative impact of the measures on patients’ recovery, differences in precautionary measures between healthcare settings and incomprehension for changes in precautionary measures.ConclusionsCPB-positivity occurred more frequently than expected in the Dutch provinces of NH and FL. Standardizing the transference of information concerning CPB-positive patients, implementing transmural agreements, training personnel on CPB knowledge and procedures, launching a national website on CPB and assigning one or several designated employees for CPB within healthcare institutions could improve communication between healthcare providers and thereby decrease the risk of CPB transmission.

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Section: Discussionsupporting

confidence: 76%

Perceived barriers and enablers for preventing the spread of carbapenem producing gram-negative bacteria during patient transfers: a mixed methods study among healthcare providers

et al. 2019

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“…The routine screening of patients for MRSA helps to appropriately manage those colonised and reduce the risk to other patients. One study used a mixed methods approach to explore the MRSA screening behaviours of UK hospital staff (Currie et al, 2019). The TDF was used to design a question schedule and analyse the results of interviews and focus groups with 49 nurses and clinical staff.…”

Section: Resultsmentioning

confidence: 99%

The use of behaviour change theory for infection prevention and control practices in healthcare settings: A scoping review

Greene

Wilson

2022

Journal of Infection Prevention

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Background Infection prevention and control (IPC) practices performed by healthcare workers are key to the prevention and management of infections. Compliance with IPC practices is often low, they are therefore commonly the focus of improvement interventions. Designing interventions that are based on behaviour change theories may help to improve compliance to practice. The aim of this review is to synthesise the evidence on the application of behaviour change theories to interventions to improve IPC practice in healthcare settings. Methods A scoping review was conducted following the Joanna Briggs Institute methodological framework. The theories of focus were the Theoretical Domains Framework (TDF), Capability, Opportunity, Motivation, Behaviour (COM-B) and Behaviour Change Wheel (BCW). Studies which applied these theories to any IPC practice were included. Results Eleven studies were identified which met the inclusion criteria. The IPC behaviours investigated were hand hygiene (7), antimicrobial stewardship (3), and MRSA screening (1). Nine studies explored barriers and facilitators to existing IPC practice; three used their findings to design a behaviour change intervention or tool. Domains of ‘beliefs about consequences’, ‘environmental context/resources’, and ‘social/professional role and identity’ were identified as key across all three IPC behaviours. Discussion This review has demonstrated the use of behavioural theories to understand determinants of behaviour related to IPC practice. Currently, there are few published examples of interventions to improve IPC practice that have been underpinned by behavioural theory. Practitioners in IPC should consider the use of these methods to enhance the efficacy of strategies to change healthcare worker behaviour.

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“…Notably, knowledge levels remained improved even three months after the education session. Understanding the barriers that impact occupational therapy practice can provide guidance for developing specific and targeted strategies to mitigate these barriers [ 45 , 46 ]. Providing education and training on methods of measuring self-awareness may also improve the clinical use of assessments.…”

Section: Discussionmentioning

confidence: 99%

Understanding the Barriers of Implementing a Self-Awareness Assessment in Occupational Therapy Practice within a Brain Injury Population: An Exploratory Study

Cheng

Tsow

Schmidt

2023

Occupational Therapy International

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Background. Self-awareness is seldom formally assessed by occupational therapists among individuals with traumatic brain injury (TBI). However, impaired self-awareness is prevalent and has a significant impact on rehabilitation outcomes. There is a need to understand clinician perspectives on self-awareness assessments and promote evidence-based practice in clinical settings. Aims. (1) Explore how an education session impacts knowledge and use of self-awareness assessments in occupational therapists working with people with TBI; (2) Understand the barriers that occupational therapists experience when assessing self-awareness in clinical practice. Materials and Methods. A single-group pre-post session design with an integrated knowledge translation approach was used. Occupational therapists working in neurorehabilitation were recruited from two rehabilitation centres through convenience sampling. Participants completed questionnaires before, after, and three months following an education session about the Self-Awareness of Deficits (SADI) assessment. Results. 14 occupational therapists participated in this study. A statistically significant increase in knowledge and confidence in using the SADI was observed both post-session and at 3-month follow-up. Conclusion. Targeted and ongoing education promotes confidence and knowledge retention among occupational therapists. Further research should explore strategies to promote behaviour change. Significance. The barriers identified in this study can provide insights for knowledge translation across clinical contexts.

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Barriers and enablers to meticillin-resistant Staphylococcus aureus admission screening in hospitals: a mixed-methods study

Cited by 9 publications

References 23 publications

Perceived barriers and enablers for preventing the spread of carbapenem producing gram-negative bacteria during patient transfers: a mixed methods study among healthcare providers

Perceived barriers and enablers for preventing the spread of carbapenem producing gram-negative bacteria during patient transfers: a mixed methods study among healthcare providers

The use of behaviour change theory for infection prevention and control practices in healthcare settings: A scoping review

Understanding the Barriers of Implementing a Self-Awareness Assessment in Occupational Therapy Practice within a Brain Injury Population: An Exploratory Study

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