Research Group of Nursing and Health Sciences, Research Department, Stavanger University Hospital, Stavanger, Norway.
Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
J Clin Nurs. 2023 Sep;32(17-18):6268-6286. doi: 10.1111/jocn.16657. Epub 2023 Feb 26.
To gain a comprehensive understanding of nurses' infection control practices, antibiotics stewardship attitudes and self-efficacy when caring for patients with multidrug-resistant bacterial infections in a hospital setting.
Multidrug-resistant bacteria cause a substantial health burden by complicating infections and prolonging hospital stays. Attitudes and self-efficacy can inform professional behaviour. Nurses' attitudes and self-efficacy concerning multidrug-resistant bacteria, infection prevention and control and antibiotic stewardship are vital in keeping patients safe.
A descriptive and convergent mixed-methods design involving quantitative and qualitative approaches was used.
Two hundred and seventeen nurses working in clinical practice at seven different hospital wards (i.e., general medicine, surgical, haematological and oncology) at a Norwegian university hospital were invited to participate. Data were collected in February and March 2020 via two questionnaires: the Multidrug-Resistant Bacteria Attitude Questionnaire and the General Perceived Self-Efficacy Scale (n = 131) and four focus group interviews (n = 22). The data were analysed using descriptive statistics and systematic text condensation.
Most nurses showed moderate knowledge, adequate behavioural intentions towards infection prevention and antibiotic stewardship, and high self-efficacy. However, they reported negative emotions towards their knowledge level and negative emotions towards nursing care. The nurses appeared uncertain about their professional influence and role in antibiotic stewardship practices. Organisational and relational challenges and ambivalent perceptions of nurses' role were potential explanations.
Nurses report moderate attitudes and high self-efficacy when caring for patients with multidrug-resistant bacterial infections. This study suggests that nurses experience organisational and relational factors in their work environment that challenge their attitudes towards infection prevention and control and antibiotic stewardship practices. Measures that strengthen their knowledge and emotional response underpin correct infection prevention and control behaviour. A role clarification is needed for antibiotic stewardship. No Patient or Public Contribution.
Measures to increase attitudes towards infection prevention and control, antibiotic stewardship and multidrug resistance is recommended. Measures should be taken to overcome organisational challenges. A clarification of the nurses' role in antibiotic stewardship is needed.
全面了解护士在医院环境中护理多重耐药菌感染患者时的感染控制实践、抗生素管理态度和自我效能。
多重耐药菌通过使感染复杂化和延长住院时间给健康带来了重大负担。态度和自我效能可以为专业行为提供信息。护士对多重耐药菌、感染预防和控制以及抗生素管理的态度和自我效能对于确保患者安全至关重要。
采用描述性和汇聚性混合方法设计，包括定量和定性方法。
邀请 217 名在挪威大学医院七个不同病房（即普通内科、外科、血液科和肿瘤科）从事临床工作的护士参加。数据于 2020 年 2 月至 3 月通过两份问卷收集：多药耐药菌态度问卷和一般感知自我效能量表（n=131）和四个焦点小组访谈（n=22）。使用描述性统计和系统文本浓缩法分析数据。
大多数护士表现出中等水平的知识、对感染预防和抗生素管理的适当行为意图以及高水平的自我效能。然而，他们报告对自己的知识水平和对护理的负面情绪。护士们对自己在抗生素管理实践中的专业影响和角色感到不确定。组织和关系方面的挑战以及对护士角色的矛盾看法可能是潜在的解释。
护士在护理多重耐药菌感染患者时报告了中等的态度和高水平的自我效能。本研究表明，护士在工作环境中经历了组织和关系因素，这些因素挑战了他们对感染预防和控制以及抗生素管理实践的态度。加强知识和情绪反应的措施可以支撑正确的感染预防和控制行为。需要明确抗生素管理的角色。无患者或公众贡献。
建议采取措施提高对感染预防和控制、抗生素管理和多重耐药性的态度。应采取措施克服组织方面的挑战。需要澄清护士在抗生素管理中的作用。
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