Cole Mark
University of Nottingham, Grantham and District Hospital, Grantham, Lincolnshire.
Br J Nurs. 2008;17(11):700-4. doi: 10.12968/bjon.2008.17.11.29615.
Healthcare-acquired infection has become a global health phenomenon affecting approximately 8.7% of the world's population. Despite a plethora of evidence-based guidelines, policies and procedures, knowledge of these can be poor, and when this is the case, sub-optimum care may follow. Historically, enhancement strategies have focused on the provision of education by making the tacit assumption that an increase in knowledge will result in an improvement in compliance. However, compliance is a multi-dimensional, abstract, complex concept that is difficult to define. Decision-making is rarely objective and the capacity of personal experience to outweigh scientific evidence is a hallmark of the post-modern times in which we live. It is well established in social psychology research that when faced with complex encounters, individuals turn to simple reasoning rules called 'heuristics', to make decisions. These heuristics are potentially dangerous as they can introduce flawed probability judgements in relation to compliance behaviour. If the raison-d'être of infection control nursing is to attain compliance with the best available evidence, organizations need to reject a reductionist, cause-and-effect view of compliance and acknowledge that compliance and infection control practice is a complex social construct.
医疗保健相关感染已成为一种全球健康现象，影响着全球约8.7%的人口。尽管有大量基于证据的指南、政策和程序，但对这些内容的了解可能并不充分，在这种情况下，可能会导致护理水平欠佳。从历史上看，强化策略一直侧重于通过默认增加知识会导致依从性提高来提供教育。然而，依从性是一个多维度、抽象、复杂的概念，难以定义。决策很少是客观的，个人经验超越科学证据的能力是我们生活的后现代时代的一个标志。社会心理学研究已经证实，当面对复杂情况时，个体会求助于称为“启发式”的简单推理规则来做出决策。这些启发式方法可能很危险，因为它们可能会在依从行为方面引入有缺陷的概率判断。如果感染控制护理的存在理由是实现对最佳现有证据的依从，那么各组织需要摒弃对依从性的简化的因果关系观点，并承认依从性和感染控制实践是一个复杂的社会建构。
