Evaluation of infection prevention and control policies, procedures, and practices: An ethnographic study

Patient and family engagement in patient safety in the Eastern Mediterranean Region: a scoping review

BACKGROUND

Patients can play a key role in delivering safe care by becoming actively involved in their health care. This study aimed at reviewing the literature for evidence of patients' and families' engagement in patient safety in the Eastern Mediterranean Region (EMR).

METHODS

We conducted a scoping review of the literature published in English using PubMed, Medline, CINAHL, Scopus, ISI Web of Science, and PsycINFO until June 2023.

RESULTS

A total of 9019 studies were screened, with 22 meeting the inclusion criteria. Our review found few published studies of patient and family engagement in patient safety research in the EMR. Thirteen studies explored the attitudes, perceptions, and/or experiences / preferences of patients, families, and healthcare providers (HCPs) regarding patient engagement in patient safety. Nine publications reported patient involvement in patient safety activities at varying levels. Three categories of factors were identified that may affect patient involvement: patient-related (e.g., lack of awareness on their role in preventing harms, unwillingness to challenge HCPs' authority, and cultural barriers); HCP-related (e.g., negative attitudes towards patient engagement, poor patient-provider communication, and high workload); and healthcare setting-related (e.g., lack of relevant policies and guidelines, lack of training for patients, and HCPs, and lack of patient-centered approach).

CONCLUSION

This review highlighted limitations in the current literature on patient and family engagement in patient safety in the EMR, including both the depth of evidence and clarity of concepts. Further research is needed to explore how to actively involve patients and their families, as well as to determine whether such involvement translates into improved safety in practice.

Nurses' and midwives' cleaning knowledge, attitudes and practices: An Australian study

Background

As frontline providers of care, nurses and midwives play a critical role in controlling infections such as COVID-19, influenza, multi-drug resistant organisms and health care associated infections. Improved cleaning can reduce the incidence of infection and is cost effective but relies on healthcare personnel to correctly apply cleaning measures. As nurses and midwives have the most contact with patients and as an important first step in improving compliance, this study sought to explore nurses' and midwives’ knowledge on the role of the environment in infection prevention and control and identify challenges in maintaining clean patient environments.

Methods

Cross-sectional online survey of 96 nurses (RN/EN) and midwives (RW) employed in clinical settings (e.g. hospital, aged care, medical centre, clinic) in Australia.

Results

Nurses and midwives broadly stated that they understood the importance of cleaning. However, cleaning responsibilities varied and there was confusion regarding the application of different disinfectants when cleaning after patients with a suspected or diagnosed infection post-discharge. Most would not be confident being placed in a room where a previous patient had a diagnosed infection such as multi-drug resistant organism.

Conclusion

Greater organisational support and improving applied knowledge about infection control procedures is needed. This includes correct use of disinfectants, which disinfectant to use for various situations, and cleaning effectively following discharge of a patient with known infection. The cleanliness of shared medical equipment may also pose current risk due to lack of cleaning.

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Improved cleaning reduces incidence of healthcare associated infection but relies on correct application.

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Nurses and midwives expressed confusion regarding disinfectant use and cleaning responsibility.

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Most would not be confident being placed in a room where a previous patient had a diagnosed infection.

Patient-Nurse Ratio is Related to Nurses' Intention to Leave Their Job through Mediating Factors of Burnout and Job Dissatisfaction

In healthcare settings, nurses’ workload, burnout, and job satisfaction are associated to the patient–nurse ratio. Whether this ratio also affects their intention to leave the nursing profession, along with the underlying stress pathway, remains unclear. This study aimed to investigate the effects of the patient–nurse ratio on nurses’ intention to leave and considering the mediating roles of burnout and job dissatisfaction. The study analyzed the data of two pooled cross-sectional surveys collected in 2013 and 2014. Measures were obtained by a structure questionnaire, which queried the average daily patient–nurse ratio (ADPNR), nurses’ personal burnout, client-related burnout, job dissatisfaction, intention to leave, and other demographics. ADPNRs were standardized according to hospital levels. Multiple regression models examined mediation hypotheses, and a percentile bootstrap confidence interval was applied to determine the significance of indirect effects. A total of 1409 full-time registered nurses in medical and surgical wards of 24 secondary or tertiary hospitals in Taiwan completed self-administered questionnaires. Most of the participants were female (97.2%), and the mean age was 29.9 years. The association between the standardized ADPNR and intention to leave their job was significantly mediated by personal burnout, client-related burnout, and job dissatisfaction. Higher standardized ADPNRs predicted higher levels of personal burnout, client-related burnout, and job dissatisfaction, each of which resulted in higher levels of intention to leave the current job. The results highlight that appropriate patient–nurse ratio standards may be further discussed by selecting personal burnout, client-related burnout, and job dissatisfaction as indicators.

Development of the peripheral and central venous catheter-related bloodstream infection prevention knowledge and attitudes scale

BACKGROUND

Because of the necessities of modern medicine, catheters are frequently used for patients today. Mistakes made in catheter implementation frequently cause nosocomial infections.

AIMS AND OBJECTIVES

The purpose of this study was to develop a scale to be used for the evaluation of nurses' knowledge and attitudes about peripheral and central venous catheter-related bloodstream infection prevention.

DESIGN AND METHODS

This methodological study was conducted between July 2016 and December 2017, with 150 nurses who worked in intensive care units and surgical, internal and paediatric clinics in hospitals located in two different cities in the eastern part of Turkey and who consented to participate in the study.

RESULTS

Item total correlation values of the scale ranged between 0.515 and 0.703. Correlation coefficient between the two measurements as a result of the test-retest reliability was found to be 0.64, and there was a linear relationship between the measurements. The Kaiser-Meyer-Olkin (KMO) value was found to be0.875, which indicates the adequacy of the sample. Barlett's test results indicated a correlation between the items (P < .01). Cronbach's alpha value of the scale was found to be 0.86.

CONCLUSIONS

Results showed that the 5-point Likert scale was formed with 14 items and two factors, which included "general precautions" and "catheter care." Scale total score is obtained by collecting all the items. Higher scores indicate higher knowledge and attitudes. This scale could be used for assessing the knowledge and attitudes of nurses about peripheral and central venous catheter-related bloodstream infection prevention precautions.

RELEVANCE TO CLINICAL PRACTICE

The Peripheral and Central Venous Catheter-Related Bloodstream Infection Prevention Knowledge and Attitudes Scale could be used for infection prevention in the assessment of the knowledge and attitudes of nurses with a view of preventing infections. The scale can be used in intensive care units and surgical, internal and paediatric clinics in order to assess nurses' knowledge and attitudes.