Bouchoucha Stephane L, Moore Kathleen A
Deakin University, Geelong, Australia, School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Burwood, Victoria, Australia.
Federation University Australia, School of Health Sciences and Psychology, Churchill, Australia.
J Infect Prev. 2018 May;19(3):131-137. doi: 10.1177/1757177417738332. Epub 2017 Nov 3.
The aim of this study was to explore the attitudes and behaviours of registered nurses and their colleagues around the adoption of standard precautions in order to determine strategies to promote adherence.
A qualitative exploratory descriptive design used interviews and focus group to collect data.
Registered nurses and registered midwifes from a tertiary metropolitan hospital took part in the study.
A voluntary sample of 29 adults was recruited from the Australian nursing (n = 25) and midwifery (n = 4) workforce. There were six men (mean age = 36.83 years; SD = 8.93) and 23 women (mean age = 41.36 years; SD = 10.25). Participants were recruited through advertisement on notice boards and emails from unit managers.
Thematic analysis revealed five themes but the focus here is on staff judgements which are against the guidelines. Participants indicated that where in their judgement the patient posed no risk and they judged themselves skilled in the procedure, they were justified in deviating from the guidelines. Some staff judgements appeared to be self-protecting, while others were irrational and inconsistent.
Despite use of standard precautions being mandated, staff often deviated from them based on their own assessment of the situation or the patient. Any deviance from the guidelines is of concern but especially so when staff take it upon themselves to apply their own criteria or judgements. These results also suggest there may be some organisational inadequacies with regards to training and supervision of staff.
本研究旨在探讨注册护士及其同事在采用标准预防措施方面的态度和行为，以确定促进依从性的策略。
采用定性探索性描述设计，通过访谈和焦点小组收集数据。
来自一家大都市三级医院的注册护士和注册助产士参与了该研究。
从澳大利亚护理人员（n = 25）和助产人员（n = 4）中自愿抽取了29名成年人作为样本。其中有6名男性（平均年龄 = 36.83岁；标准差 = 8.93）和23名女性（平均年龄 = 41.36岁；标准差 = 10.25）。参与者通过布告栏上的广告和科室经理发送的电子邮件招募。
主题分析揭示了五个主题，但这里重点关注的是与指南相悖的员工判断。参与者表示，在他们判断患者没有风险且他们自认为在操作上熟练的情况下，偏离指南是合理的。一些员工的判断似乎是自我保护，而另一些则是不合理且不一致的。
尽管标准预防措施是强制性的，但员工经常根据自己对情况或患者的评估而偏离这些措施。任何偏离指南的行为都令人担忧，尤其是当员工自行采用自己的标准或判断时。这些结果还表明，在员工培训和监督方面可能存在一些组织上的不足。
