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探索接受造血干细胞移植的成年患者每日使用葡萄糖酸氯己定沐浴的促进因素和障碍。

Exploring facilitators and barriers to daily chlorhexidine gluconate bathing in adult patients undergoing hematopoietic stem cell transplantation.

作者信息

Artese Ashley L, Sainvil Michele, Fish Laura J, Hill Lauren, Somers Tamara, Matthews Anita, Blazek Leah, Sito Elizabeth, Andermann Tessa, Rezvani Andrew R, Choi Taewoong, Gasparetto Cristina J, Horwitz Mitchell E, Long Gwynn D, Lopez Richard D, Rizzieri David A, Sarantopoulos Stefanie, Chao Nelson J, Allen Deborah H, Hong Sanghee, Sung Anthony D

机构信息

Department of Exercise Science and Health Promotion, Florida Atlantic University, 777 Glades Road, Boca Raton, FL, USA.

Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC, USA.

出版信息

Support Care Cancer. 2024 Nov 28;32(12):833. doi: 10.1007/s00520-024-09037-6.

Abstract

UNLABELLED

Hematopoietic cell transplantation (HCT) is a promising treatment for hematologic malignancies, but intensive conditioning leads to immunosuppression and susceptibility to healthcare-associated infections (HAI). Despite standard prevention measures, bloodstream infections (BSI) impact a significant percentage of immunocompromised HCT patients. Incidence of BSI can be mitigated by chlorhexidine gluconate (CHG) bathing-an underutilized infection-prevention strategy. Gaining HCT recipients' perceptions on CHG bathing can inform strategies to improve adherence and enhance patient outcomes.

PURPOSE

This study explored patients' perceived facilitators, barriers, and education/knowledge related to CHG bathing and thus addresses the gap in implementation for immunocompromised HCT patients.

METHODS

This study used a qualitative description approach to explore patients' perceived facilitators, barriers, and knowledge of CHG bathing. Fourteen HCT recipients (mean 51 ± 16 years) completed semi-structured interviews. Data were analyzed using a rapid qualitative analysis approach to identify themes.

RESULTS

Participants identified facilitators to using CHG wipes including ease of use, comfort, and staff assistance, along with barriers including wait time, discomfort, and physical challenges. Patient education themes encompassed patient understanding of CHG purpose, perceived ease in learning/application, inconsistent instruction, and inconsistent procedures.

CONCLUSION

CHG bathing is a valuable infection prevention strategy for HCT patients. Participants' perspectives highlight the importance of addressing practical challenges and improving education to enhance adherence. This study contributes insights from HCT recipients, emphasizing the need for patient-centered interventions to reduce HAI and improve overall patient care.

摘要

未标注

造血细胞移植(HCT)是治疗血液系统恶性肿瘤的一种有前景的方法,但强化预处理会导致免疫抑制以及易患医疗相关感染(HAI)。尽管采取了标准的预防措施,血流感染(BSI)仍影响着相当比例的免疫受损HCT患者。葡萄糖酸氯己定(CHG)沐浴是一种未得到充分利用的感染预防策略,可降低BSI的发生率。了解HCT受者对CHG沐浴的看法有助于制定提高依从性和改善患者结局的策略。

目的

本研究探讨了患者对CHG沐浴的感知促进因素、障碍以及教育/知识,从而填补了免疫受损HCT患者在实施方面的空白。

方法

本研究采用定性描述方法来探讨患者对CHG沐浴的感知促进因素、障碍和知识。14名HCT受者(平均年龄51±16岁)完成了半结构化访谈。使用快速定性分析方法对数据进行分析以确定主题。

结果

参与者确定了使用CHG擦拭巾的促进因素,包括使用方便、舒适和工作人员协助,以及障碍,包括等待时间、不适和身体挑战。患者教育主题包括患者对CHG用途的理解、学习/应用的感知难易程度、指导不一致和程序不一致。

结论

CHG沐浴是HCT患者一种有价值的感染预防策略。参与者的观点强调了应对实际挑战和改善教育以提高依从性的重要性。本研究提供了HCT受者的见解,强调了以患者为中心的干预措施对于减少HAI和改善整体患者护理的必要性。

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