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影响医务人员接受标准预防措施态度的因素。

Factors Shaping Attitudes of Medical Staff towards Acceptance of the Standard Precautions.

机构信息

Institute of Economics, Finance and Management, Faculty of Management and Social Communication, Jagiellonian University, ul. Łojasiewicza 4, 30-348 Kraków, Poland.

Department of Microbiology, Faculty of Medicine, Jagiellonian University Collegium Medicum, ul. Czysta 18, 31-121 Kraków, Poland.

出版信息

Int J Environ Res Public Health. 2019 Mar 23;16(6):1050. doi: 10.3390/ijerph16061050.

Abstract

Standard precautions (SPs) guidelines are the minimum infection prevention practices that apply to all types of patient care, regardless of suspected or confirmed infection status of the patient. They are based on risk assessment, make use of common sense practices and personal protective equipment that protect healthcare providers from infection and prevent the spread of infection from patient to patient. The aim of this study was to determine medical staff's attitudes towards SPs and analyse the factors shaping these attitudes. The study was conducted using a questionnaire that comprised 25 statements describing the attitudes of medical personnel towards SPs. They were designed to pinpoint the factors that determine these attitudes. There were five factors identified that shape employees' attitudes towards SPs: assessment of the situation, favourable patterns of behaviour, negative norms, unfavourable patterns of behaviour and rationalising. The study analysed 505 questionnaires filled in by hospital workers from five Polish cities. The majority of the respondents were women (92.1%), nurses (87.5%); the average age was 41.8 and the average seniority was 19.2 years. Over one-third of the respondents worked in non-surgical (36.4%) and surgical (31.6%) wards, 12.3% were employed in intensive care units (ICUs) and 8.9% in emergency departments (EDs). The variable significantly affecting the level of acceptance of SPs was seniority: initially the support was high, then it later decreased, with the greatest decrease occurring between the third and eighth year of work. The staff of medical wards and ICUs demonstrated significantly lower support for SPs and strong environmental impact on SPs perception; low degree of acceptance among medical ward staff correlated negatively with factors from the category "favourable patterns of behaviour". The substantially strongest support for SPs was found in ED workers. The results indicate the need for continuous education of individual groups of workers concerning the application of SPs, but also the necessity to change the organisational culture in Polish hospitals.

摘要

标准预防措施 (SPs) 指南是适用于所有类型患者护理的最低感染预防实践,无论患者的感染状态是疑似还是确诊。它们基于风险评估,利用常识性做法和个人防护设备来保护医疗保健提供者免受感染,并防止感染从患者传播到患者。本研究旨在确定医务人员对 SPs 的态度,并分析影响这些态度的因素。该研究使用了一份包含 25 个描述医务人员对 SPs 态度的陈述的问卷进行。这些陈述旨在确定决定这些态度的因素。确定了五个因素可以塑造员工对 SPs 的态度:对情况的评估、有利的行为模式、负面规范、不利的行为模式和合理化。该研究分析了来自波兰五个城市的 505 份医院工作人员填写的问卷。大多数受访者是女性(92.1%),护士(87.5%);平均年龄为 41.8 岁,平均工龄为 19.2 年。超过三分之一的受访者在非外科(36.4%)和外科(31.6%)病房工作,12.3%在重症监护病房(ICU)工作,8.9%在急诊部(ED)工作。显著影响 SPs 接受程度的变量是工龄:最初的支持率很高,然后后来下降,工作第三至第八年下降幅度最大。医疗病房和 ICU 的工作人员对 SPs 的支持明显较低,对 SPs 感知的环境影响较大;医疗病房工作人员对 SPs 的接受程度较低与“有利的行为模式”类别中的因素呈负相关。ED 工作人员对 SPs 的支持最强。研究结果表明,需要对各个群体的工作人员进行有关 SPs 应用的持续教育,但也需要改变波兰医院的组织文化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9095/6466440/96d4f8340add/ijerph-16-01050-g001.jpg

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