Seibert Dorothy J, Speroni Karen Gabel, Oh Kyeung Mi, Devoe Mary C, Jacobsen Kathryn H
School of Nursing, George Mason University, Fairfax, VA.
Inova Fair Oaks Hospital, Fairfax, VA.
Am J Infect Control. 2014 Apr;42(4):405-11. doi: 10.1016/j.ajic.2013.10.008. Epub 2014 Feb 20.
Health care workers' (HCWs) perceptions and attitudes affect implementation of precautions to prevent transmission of drug-resistant pathogens such as methicillin-resistant Staphylococcus aureus (MRSA). Identification of challenges and barriers to recommended practices is a critical component of promoting a safe clinical environment of care.
Semistructured interviews addressed how MRSA affects HCWs, prevention of transmission, and challenges and barriers HCWs experience when entering a MRSA isolation room and performing appropriate hand hygiene.
The purposive sample of 26 acute care HCWs (16 registered nurses; 1 physician; 6 allied health professionals; and 3 support staff) self-selected from 276 responding to a questionnaire on MRSA. Analysis identified 18 themes across seven categories. Most participants reported feeling responsible for preventing transmission, and having the knowledge and desire to do so. However, many also reported challenges to following consistent hand hygiene and use of contact precautions. Barriers included patient care demands, equipment and environmental issues such as availability of sinks, time pressures, the practices of other HCWs, and the need for additional signs indicating which patients require contact precautions.
The HCWs reported a need for improved clarity of isolation protocols throughout patients' hospital journey, additional rooms and staff for isolation patients, improved education and communication (including timely and appropriate signage), and an emphasis on involving all HCWs in reducing contamination.
医护人员的认知和态度会影响预防耐甲氧西林金黄色葡萄球菌（MRSA）等耐药病原体传播的预防措施的实施。识别推荐做法的挑战和障碍是促进安全临床护理环境的关键组成部分。
半结构化访谈探讨了MRSA如何影响医护人员、传播的预防以及医护人员进入MRSA隔离病房并进行适当手部卫生时所经历的挑战和障碍。
从276名回复MRSA调查问卷的人员中自行选取了26名急性护理医护人员作为目标样本（16名注册护士；1名医生；6名专职医疗人员；3名辅助人员）。分析确定了七个类别中的18个主题。大多数参与者表示感到有责任预防传播，并且有这样做的知识和意愿。然而，许多人也报告了在遵循一致的手部卫生和使用接触预防措施方面存在挑战。障碍包括患者护理需求、设备和环境问题，如洗手池的可用性、时间压力、其他医护人员的做法，以及需要额外的标识来表明哪些患者需要接触预防措施。
医护人员报告称，需要在患者的整个住院过程中提高隔离协议的清晰度，为隔离患者增加病房和工作人员，改善教育和沟通（包括及时和适当的标识），并强调让所有医护人员参与减少污染。
