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Vaillant L, Birgand G, Esposito-Farese M, Astagneau P, Pulcini C, Robert J, Zahar JR, Sales-Wuillemin E, Tubach F, Lucet JC. Awareness among French healthcare workers of the transmission of multidrug resistant organisms: a large cross-sectional survey. Antimicrob Resist Infect Control 2019; 8:173. [PMID: 31749961 PMCID: PMC6852912 DOI: 10.1186/s13756-019-0625-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 10/15/2019] [Indexed: 11/10/2022] Open
Abstract
Background Much effort has been made over the last two decades to educate and train healthcare professionals working on antimicrobial resistance in French hospitals. However, little has been done in France to assess perceptions, attitudes and knowledge regarding multidrug resistant organisms (MDROs) and, more globally, these have never been evaluated in a large-scale population of medical and non-medical healthcare workers (HCWs). Our aim was to explore awareness among HCWs by evaluating their knowledge of MDROs and the associated control measures, by comparing perceptions between professional categories and by studying the impact of training and health beliefs. Methods A multicentre cross-sectional study was conducted in 58 randomly selected French healthcare facilities with questionnaires including professional and demographic characteristics, and knowledge and perception of MDRO transmission and control. A knowledge score was calculated and used in a logistic regression analysis to identify factors associated with higher knowledge of MDROs, and the association between knowledge and perception. Results Between June 2014 and March 2016, 8716/11,753 (participation rate, 74%) questionnaires were completed. The mean knowledge score was 4.7/8 (SD: 1.3) and 3.6/8 (SD: 1.4) in medical and non-medical HCWs, respectively. Five variables were positively associated with higher knowledge: working in a university hospital (adjusted odds ratio, 1.41, 95% CI 1.16–1.70); age classes 26–35 years (1.43, 1.23–1.6) and 36–45 years (1.19, 1.01–1.40); medical professional status (3.7, 3.09–4.44), working in an intensive care unit (1.28, 1.06–1.55), and having been trained on control of antimicrobial resistance (1.31, 1.16–1.48). After adjustment for these variables, greater knowledge was significantly associated with four cognitive factors: perceived susceptibility, attitude toward hand hygiene, self-efficacy, and motivation. Conclusions We found a low level of MDRO awareness and knowledge of associated control measures among French HCWs. Training on hand hygiene and measures to control MDRO spread may be helpful in shaping beliefs and perceptions on MDRO control among other possible associated factors. Messages should be tailored to professional status and their perception. Other approaches should be designed, with more effective methods of training and cognitive interventions. Trial registration Clinical Trials.gov NCT02265471. Registered 16 October 2014 - Retrospectively registered.
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Affiliation(s)
- L Vaillant
- AP-HP, Bichat-Claude Bernard Hospital, Infection Control Unit, 48 rue Henri Huchard, F-75018 Paris, France
| | - G Birgand
- 2Department of Medicine, NIHR, Imperial College London, Health Protection Research Unit in Antimicrobial Resistance and Healthcare Associated Infection Imperial College London, South Kensington Campus, London, SW7 2AZ UK
| | - M Esposito-Farese
- AP-HP, Bichat-Claude Bernard Hospital, Unité de Recherche Clinique Paris Nord Val de Seine and CIC-EC 1425, 48 rue Henri Huchard, F-75018 Paris, France
| | - P Astagneau
- 4Medecine Sorbonne University, AP-HP, Regional centre for Prevention of Healthcare-associated infections, 8 rue Maria Helena Vieira da Silva, 75014 Paris, France
| | - C Pulcini
- 5EA 4360 APEMAC, CHRU de Nancy, University of Lorraine, Infectious and Tropical Diseases Unit, 34 Cours Léopold, 54000 Nancy, France
| | - J Robert
- Sorbonne University, U1135, Team E13, CR7 INSERM, AP-HP, Pitié-Salpêtrière Hospital, Bactériologie-Hygiène, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - J R Zahar
- 7AP-HP, Avicenne Hospital, Infection Control Unit, 125 Rue de Stalingrad, 93000 Bobigny, France.,8University of Paris, INSERM, IAME, UMR 1137, Paris, France
| | | | - F Tubach
- INSERM, UMR 1123, AP-HP, Pitié-Salpêtrière Hospital, Centre de Pharmacoépidémiologie (Cephepi), 75013 Paris, France
| | - J C Lucet
- AP-HP, Bichat-Claude Bernard Hospital, Infection Control Unit, 48 rue Henri Huchard, F-75018 Paris, France.,8University of Paris, INSERM, IAME, UMR 1137, Paris, France
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Celeste C, Jolivet S, Bonneton M, Brun-Buisson C, Jansen C. Healthcare workers' knowledge and perceptions of the risks associated with emerging extensively drug-resistant bacteria. Med Mal Infect 2017; 47:459-469. [PMID: 28943168 DOI: 10.1016/j.medmal.2017.05.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 08/23/2016] [Accepted: 05/31/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Guidelines have been issued in 2010 to prevent the spread of emerging extensively resistant bacteria (eXDR), but their implementation is difficult. We aimed to evaluate healthcare workers' (HCW) knowledge and their risk perception to identify barriers to the implementation of guidelines. METHODS Semi-structured interviews were conducted at a University Hospital, where case patients are regularly admitted. The interviews focused on HCW's knowledge, risk perception, and challenges met. The evaluation of HCW's knowledge and contagiousness and perception of severity of eXDR carriage were analyzed statistically. Risk perception and opinion about guidelines were analyzed by qualitative description. RESULTS One hundred and twenty-one HCWs were interviewed. The category of HCW, having searched for information on resistant bacteria, and having taken care of case patients were associated with better knowledge. The HCW category, age, type of unit, seniority, and having taken care of case patients were associated with risk perceptions. Qualitative analysis identified 61 themes. HCWs were extremely concerned by the spread of bacteria within the hospital. The main challenges identified were organizational and communication issues. CONCLUSION HCWs reported a lack of knowledge and a lack of resources to implement guidelines. Strategies to improve guidelines implementation must be based on a better availability of resources, better communication, and new educational methods.
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Affiliation(s)
- C Celeste
- Université Claude-Bernard, Lyon 1, 69100 Villeurbanne, France; Unité de contrôle, épidémiologie et prévention de l'infection (CEPI), groupe Henri-Mondor-Albert-Chenevier, Assistance publique-Hôpitaux de Paris, 94000 Créteil, France
| | - S Jolivet
- Unité de contrôle, épidémiologie et prévention de l'infection (CEPI), groupe Henri-Mondor-Albert-Chenevier, Assistance publique-Hôpitaux de Paris, 94000 Créteil, France; Université Paris Est-Créteil, 94000 Créteil, France
| | - M Bonneton
- Unité de contrôle, épidémiologie et prévention de l'infection (CEPI), groupe Henri-Mondor-Albert-Chenevier, Assistance publique-Hôpitaux de Paris, 94000 Créteil, France
| | - C Brun-Buisson
- Unité de contrôle, épidémiologie et prévention de l'infection (CEPI), groupe Henri-Mondor-Albert-Chenevier, Assistance publique-Hôpitaux de Paris, 94000 Créteil, France; Université Paris Est-Créteil, 94000 Créteil, France.
| | - C Jansen
- Unité de contrôle, épidémiologie et prévention de l'infection (CEPI), groupe Henri-Mondor-Albert-Chenevier, Assistance publique-Hôpitaux de Paris, 94000 Créteil, France
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Understanding risk perceptions and responses of the public and health care professionals toward Clostridium difficile: A qualitative interpretive description study. Am J Infect Control 2017; 45:133-138. [PMID: 27789069 DOI: 10.1016/j.ajic.2016.07.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 07/05/2016] [Accepted: 07/06/2016] [Indexed: 01/21/2023]
Abstract
BACKGROUND The occurrence of Clostridium difficile infection is a major health-related risk. How the public and health care professionals perceive and respond to a health-related risk is shaped by socially and contextually structured evaluations and interpretations. Risk perceptions and responses are context dependent and therefore need to be understood within the context in which they are perceived and experienced. METHODS This interpretive description study used 8 public focus groups (39 participants) and 7 health care professional focus groups (29 participants) in 2 geographic areas (an area that had experienced a C difficile outbreak and an area that had not). RESULTS Both the public and health care professionals expressed varying concerns about the perceived consequences of C difficile occurring and the potential influence on emotional and physical health and well-being. In doing so, they drew upon a range of direct and indirect experiences and accounts from the media. Conceptual factors found to be important in influencing risk perceptions and responses included feelings of vulnerability, attribution of responsibility, judgments about competence, and evaluations of risk communicators. CONCLUSIONS If risk management and communication strategies are to achieve desired responses toward C difficile and wider risks, those responsible for managing risk must consider already established risk perceptions in addition to factors that have influenced them.
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Burnett E, Johnston B, Corlett J, Kearney N. Constructing identities in the media: newspaper coverage analysis of a major UK Clostridium difficile outbreak. J Adv Nurs 2013; 70:1542-52. [PMID: 24224760 DOI: 10.1111/jan.12305] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2013] [Indexed: 11/30/2022]
Abstract
AIM To examine how a major Clostridium difficile outbreak in the UK was represented in the media. BACKGROUND Clostridium difficile is a serious health care-associated infection with significant global prevalence. As major outbreaks have continued to occur worldwide over the last few decades, it has also resulted in increasing media coverage. Newspaper journalists are, however, frequently criticized for sensationalized and inaccurate reporting and alarming the public. Despite such criticisms, nothing is known about how the media frame Clostridium difficile related coverage. DESIGN Qualitative interpretive descriptive study. METHOD An interpretive analysis of newspaper articles from the national press that reported about the outbreak from the first day of coverage over 3 weeks (12 June-3 July 2008). FINDINGS Twenty-eight newspaper articles were included in the study from tabloids, broadsheets, a regional and a Sunday newspaper. Monster and war metaphors were frequently adopted to portray the severity of Clostridium difficile and the impact it can have on patient safety. In addition, the positioning of the affected patients, their families, healthcare professionals and the Government produced representations of victims, villains and heroes. This subsequently evoked notions of vulnerability, blame and conflict. CONCLUSION The media are and will remain critical convectors of public information and, as such, are hugely influential in risk perceptions and responses. Rather than simply dismissing media coverage, further understanding around how such stories in specific contexts are constructed and represented is needed so that it can help inform future communication and management strategies.
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Affiliation(s)
- Emma Burnett
- School of Nursing and Midwifery, University of Dundee, UK
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