Felemban Ohood, St John Winsome, Shaban Ramon Zenel
Assistant Professor, School of Nursing, King Abdul-Aziz University, Jeddah, Saudi Arabia.
Adjunct Associate Professor, Population and Social Health Research Group, Menzies Health Institute Queensland, Griffith University, Queensland, Australia.
Br J Community Nurs. 2015 Sep;20(9):451-7. doi: 10.12968/bjcn.2015.20.9.451.
The aim of this case study was to explore the environmental challenges nurses experience with infection control practice, and the strategies they use to overcome those challenges.
An exploratory case study was conducted in four home visiting nursing organisations in southeast Queensland, Australia, using data triangulation (document review, individual interviews, and focus groups). Data were analysed using a framework approach to identify themes.
Three major infection prevention and control challenges were experienced in the community context. The first challenge is the nature of the work environment, including: poor cleanliness in clients' home environments, pets or vermin, inadequate hand-washing facilities, and a lack of appropriate storage space for clinical materials. The second challenge occurs when nurses lack access to appropriate infection control equipment, including wound-management materials and sharps containers. The third challenge is dealing with clients' poor personal hygiene and health status. Participants addressed these issues by offering assistance, using clean surfaces at clients' homes, applying an alcohol-based hand rub, providing client education, and reducing the cost of purchasing equipment for clients.
It is imperative that policy is developed to support nurses' decision making and practices as they address infection control challenges in the community environment. Ensuring staff are well-supported with resources, education, policy, and guidelines to address these challenges is important for the delivery of safe and high-quality care in community settings.
本案例研究旨在探讨护士在感染控制实践中所面临的环境挑战，以及他们用以克服这些挑战的策略。
在澳大利亚昆士兰州东南部的四个家庭访视护理机构开展了一项探索性案例研究，采用数据三角互证法（文件审查、个人访谈和焦点小组）。运用框架分析法对数据进行分析以确定主题。
在社区环境中遇到了三大感染预防与控制挑战。第一个挑战是工作环境的性质，包括：客户家庭环境清洁状况差、有宠物或害虫、洗手设施不足以及临床材料缺乏合适的存储空间。第二个挑战是护士无法获得合适的感染控制设备，包括伤口处理材料和锐器盒。第三个挑战是应对客户个人卫生和健康状况不佳的问题。参与者通过提供协助、在客户家中使用清洁表面、涂抹含酒精的洗手液、对客户进行教育以及降低为客户购买设备的成本来解决这些问题。
制定政策以支持护士在应对社区环境中的感染控制挑战时的决策和实践至关重要。确保工作人员在资源、教育、政策和指南方面得到充分支持以应对这些挑战，对于在社区环境中提供安全和高质量护理至关重要。
