Department of Biomedicine and Prevention, Tor Vergata University of Rome, via Montpellier 1, 00133 Rome, Italy.
Research Unit Nursing Science, Campus Bio-Medico University of Rome, via Álvaro del Portillo 21, 00128 Rome, Italy.
Appl Nurs Res. 2019 Oct;49:35-40. doi: 10.1016/j.apnr.2019.07.007. Epub 2019 Jul 30.
Aim To explore factors that influence intensive care nurses' experiences of being compliant with standard precautions (SP) during emergencies.
Intensive care nurses can be exposed to a greater risk of biohazardous exposure during an emergency. The primary strategy to address the complex variety of biological hazards in clinical practice is represented by the implementation of SP guidelines. Previous research has indicated that nurses' compliance rates with SPs are suboptimal, but no study has focused on the factors influencing compliance during an emergency.
A descriptive qualitative study was conducted in an Italian university hospital with 19 intensive care nurses who had at least two years of work experience in critical care. The nurses were interviewed in four focus groups and were asked about their experiences of being compliant with SPs during an emergency. Data were analyzed using conventional content analysis.
Three themes emerged: conflict, competencies, and context. Conflict was reported regarding the need to save the patient and the need for self-protection through the use of SPs. In particular, nurses had to manage the pressure of limited time. Competencies were identified by nurses' knowledge, attitude, skills, training, and experience. Context was related to the work and organizational conditions during the emergency, including overcrowding.
To support intensive care nurses' compliance with SPs during emergencies, conflict, competencies, and context should be audited regularly in clinical practice. The findings of this study could inform infection control programs and training that targets intensive care nurses.
探讨影响重症监护护士在紧急情况下遵守标准预防措施(SP)的因素。
在紧急情况下,重症监护护士可能面临更大的生物危害暴露风险。在临床实践中,应对复杂多样的生物危害的主要策略是实施 SP 指南。先前的研究表明,护士对 SP 的遵守率并不理想,但没有研究关注紧急情况下的遵守因素。
在意大利一家大学医院进行了一项描述性定性研究,共有 19 名重症监护护士参加,他们在重症监护领域至少有两年的工作经验。对护士进行了四次焦点小组访谈,询问他们在紧急情况下遵守 SP 的经验。使用常规内容分析对数据进行分析。
出现了三个主题:冲突、能力和背景。冲突涉及到需要拯救病人和通过使用 SP 进行自我保护的需要。特别是,护士必须应对时间有限的压力。能力由护士的知识、态度、技能、培训和经验确定。背景与紧急情况下的工作和组织条件有关,包括过度拥挤。
为了支持重症监护护士在紧急情况下遵守 SP,应定期在临床实践中审查冲突、能力和背景。本研究的结果可以为感染控制计划和针对重症监护护士的培训提供信息。