1
|
Way A, Bond M, Nanna B, Wright ES. Evaluating the long-term portrayal of antibiotic resistance in major U.S. newspapers. BMC Public Health 2023; 23:1343. [PMID: 37438767 PMCID: PMC10339640 DOI: 10.1186/s12889-023-16203-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/27/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Popular media play a critical role in informing the public about antibiotic resistance, which has remained a health concern for over seven decades. Media attention increases the notoriety of antibiotic resistance and shapes the public's perception of its severity, causes, and solutions. Therefore, it is critical the media accurately portray scientific knowledge that may shape personal and policy responses to antibiotic resistance. METHODS We analyzed articles from two major U.S. newspapers, The New York Times and Los Angeles Times, from 1940 to 2019 to assess trends in sentiment and lexicon surrounding antibiotic and antimicrobial resistance. RESULTS We observed a gradual increase in the number of relevant articles about resistance, although far fewer than other topics with comparable mortality rates. We found a consistently threatening portrayal of antibiotic resistance as a crisis, reflected in the usage of terms such as "superbug" to refer to some pathogens. Governmental agencies responsible for determining antibiotic usage policies were infrequently mentioned in articles. Blame for resistance was almost exclusively attributed to inappropriate antibiotic use, mainly in animals, rather than appropriate uses of antibiotics. CONCLUSIONS Collectively, our results provide insights into how popular media can more accurately inform the public about antibiotic resistance. Potential changes include increasing news coverage, avoiding fear-mongering, and adequately conveying the multiple uses of antibiotics that can potentiate resistance.
Collapse
Affiliation(s)
- Allison Way
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15219, USA
| | - Maria Bond
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15219, USA
| | - Bradley Nanna
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15219, USA
| | - Erik S Wright
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15219, USA.
- Center for Evolutionary Biology and Medicine, Pittsburgh, PA, 15219, USA.
| |
Collapse
|
2
|
Eqylan SB, Safadi RR, Swigart V. The Lived Experience of Critically-Ill Muslim Patients in Isolation. Int J Qual Stud Health Well-being 2022; 17:2032548. [PMID: 35133254 PMCID: PMC8925921 DOI: 10.1080/17482631.2022.2032548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose This study explored critically ill Muslim patients’ experiences and perceptions related to confinement to isolation rooms. Methods The descriptive–interpretive lens of phenomenology was employed to explore and illuminate the isolation experience of critically ill Muslim patients). Semi-structured, face-to-face, audiotaped interviews were conducted . Colaizzi’s method of data analysis, in combination with an interpretive analysis supported by van Manen’s “lifeworld constituents” were used. Results Data analysis revealed four themes: Feeling isolated and imprisoned; losing basic patients’ rights; feeling rejected by healthcare providers; and accepting isolation and its adversity. Findings were illuminated by applying van Manen’s lifeworld constituents: spatiality, temporality, relationality and corporeality. The patients described the overwhelming impact of isolation on their physical, emotional, social and spiritual health. Conclusions This study provides healthcare providers with an in-depth understanding of critically ill patients’ physical, psychological and spiritual needs. Although the unique needs of Muslim patients are highlighted, it is evident that patients’ suffering in isolation is universal. Healthcare providers are encouraged to consider creative measures to support and help patients cope with the adversity of isolation.
Collapse
Affiliation(s)
- Sondos B. Eqylan
- Clinical Nurse Specialist, Al-Hussein Salt New Hospital, Salt, Jordan
| | - Reema R Safadi
- Maternity and Child Health Nursing Department, School of Nursing, The University of Jordan, Amman, Jordan
| | - Valerie Swigart
- Professor, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
3
|
Yoo YJ, Kwak EJ, Jeong KM, Baek SH, Baek YS. Knowledge, attitudes and practices regarding methicillin-resistant Staphylococcus aureus (MRSA) infection control and nasal MRSA carriage rate among dental health-care professionals. Int Dent J 2018; 68:359-366. [PMID: 29577266 DOI: 10.1111/idj.12388] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Dental health-care professionals (DHCPs) with nasal colonisation of methicillin-resistant Staphylococcus aureus (MRSA) can serve as a reservoir for MRSA transmission to others and be exposed to self-contamination with MRSA. Evaluating the knowledge, attitudes and actual practice of DHCPs is imperative for appropriate infection control. METHODS Dentists, dental hygienists and dental technologists from Seoul National University Dental Hospital were recruited to participate in a cross-sectional survey and undergo nasal sampling of MRSA. The survey included demographic questions, six questions about knowledge, eight questions about attitudes/perceptions and six questions about practices/behaviours regarding MRSA infection control. Nasal samples from the participants were analysed for MRSA presence, antimicrobial susceptibility and staphylococcal cassette chromosome mec (SCCmec) typing. MRSA carriers underwent decolonisation with topical mupirocin. RESULTS Among 139 DHCPs, four (2.9%) were nasal MRSA carriers. Decolonisation was successful in three participants. One participant was decolonised with topical fusidic acid after failure to decolonise with mupirocin. Dentists had a higher knowledge score compared with the other professionals (P < 0.05). Dental hygienists scored higher on practice questions compared with the other professionals (P < 0.05). There was a significant, positive correlation between attitude and practice scores (P < 0.01). CONCLUSIONS The nasal MRSA carriage rate among DHCPs is 2.9%, which is higher than that in the general population but lower than that in other health-care professionals. Further education of DHCPs on MRSA, especially regarding its seriousness, is needed to improve MRSA infection control in a dental hospital setting.
Collapse
Affiliation(s)
- Yeon-Jee Yoo
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University School of Dentistry, Seoul National University Dental Hospital, Seoul, Korea.,Department of Comprehensive Treatment Center, Seoul National University Dental Hospital, Seoul, Korea
| | - Eun-Jung Kwak
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seoul, Korea
| | - Kyung Muk Jeong
- Department of Dermatology, College of Medicine, Korea University, Seoul, Korea
| | - Seung-Ho Baek
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University School of Dentistry, Seoul National University Dental Hospital, Seoul, Korea
| | - Yoo Sang Baek
- Department of Dermatology, College of Medicine, Korea University, Seoul, Korea
| |
Collapse
|
4
|
Twiddy M, Czoski Murray CJ, Mason SJ, Meads D, Wright JM, Mitchell ED, Minton J. A qualitative study of patients' feedback about Outpatient Parenteral Antimicrobial Therapy (OPAT) services in Northern England: implications for service improvement. BMJ Open 2018; 8:e019099. [PMID: 29326190 PMCID: PMC5781150 DOI: 10.1136/bmjopen-2017-019099] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 11/02/2017] [Accepted: 11/28/2017] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Outpatient parenteral antimicrobial therapy (OPAT) provides opportunities for improved cost savings, but in the UK, implementation is patchy and a variety of service models are in use. The slow uptake in the UK and Europe is due to a number of clinical, financial and logistical issues, including concern about patient safety. The measurement of patient experience data is commonly used to inform commissioning decisions, but these focus on functional aspects of services and fail to examine the relational aspects of care. This qualitative study examines patients' experiences of OPAT. DESIGN In-depth, semistructured interviews. SETTING Purposive sample of OPAT patients recruited from four acute National Health Service (NHS) Trusts in Northern England. These NHS Trusts between them represented both well-established and recently set-up services running nurse at home, hospital outpatient and/or self-administration models. PARTICIPANTS We undertook 28 semistructured interviews and one focus group (n=4). RESULTS Despite good patient outcomes, experiences were coloured by patients' personal situation and material circumstances. Many found looking after themselves at home more difficult than they expected, while others continued to work despite their infection. Expensive car parking, late running services and the inconvenience of waiting in for the nurse to arrive frustrated patients, while efficient services, staffed by nurses with the specialist skills needed to manage intravenous treatment had the opposite effect. Many patients felt a local, general practitioner or community health centre based service would resolve many of the practical difficulties that made OPAT inconvenient. Patients could find OPAT anxiety provoking but this could be ameliorated by staff taking the time to reassure patients and provide tailored information. CONCLUSION Services configurations must accommodate the diversity of the local population. Poor communication can leave patients lacking the confidence needed to be a competent collaborator in their own care and affect their perceptions of the service.
Collapse
Affiliation(s)
| | | | - Samantha J Mason
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - David Meads
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Judy M Wright
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | - Jane Minton
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| |
Collapse
|
5
|
Park J, Seale H. Examining the online approaches used by hospitals in Sydney, Australia to inform patients about healthcare associated infections and infection prevention strategies. BMC Infect Dis 2017; 17:788. [PMID: 29268700 PMCID: PMC5740953 DOI: 10.1186/s12879-017-2899-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 12/10/2017] [Indexed: 11/19/2022] Open
Abstract
Background Provision of information plays a critical role in supporting patients to be engaged or empowered to be involved with infection prevention measures in hospitals. This explorative study evaluated the suitability, readability and accessibility of information on healthcare associated infections (HCAIs) and infection prevention strategies targeted at patients from the websites of 19 acute care public hospitals in Sydney, Australia. Methods We included hospitals with greater than 200 beds in the sample. We examined online information targeted at patients on HCAIs and infection prevention and compared it using the Suitability Assessment of Material (SAM) and Simple Measure of Gobbledygook (SMOG) readability formulas for suitability, readability and accessibility. Results Thirty-six webpages were identified as being relevant and containing information about HCAIs or infection prevention. Based on the SAM/SMOG scores, only three webpages were found to be ‘superior’. Many of the webpages scored poorly in content, literacy, graphics, learning stimulation and cultural appropriateness. In comparison, most of the webpages scored well in the layout and typography. The majority (97%) of the materials were written at a level higher than the recommended reading grade level. Lastly, the websites scored poorly on the ability to locate the information easily, as messages about HCAIs/infection prevention were usually embedded into other topics. Conclusion While providing information online is only one approach to delivering messages about infection prevention, it is becoming increasingly important in today’s technology society. Hospitals are neglecting to use best practices when designing their online resources and current websites are difficult to navigate. The findings point to the need to review patient information on HCAIs regarding suitability, readability and accessibility.
Collapse
Affiliation(s)
- J Park
- School of Public Health and Community Medicine, University of New South Wales, Level 2, Samuels Building, Sydney, NSW, Australia
| | - H Seale
- School of Public Health and Community Medicine, University of New South Wales, Level 2, Samuels Building, Sydney, NSW, Australia.
| |
Collapse
|
6
|
Collins LC, Jaspal R, Nerlich B. Who or what has agency in the discussion of antimicrobial resistance in UK news media (2010-2015)? A transitivity analysis. Health (London) 2017. [PMID: 28637360 DOI: 10.1177/1363459317715777] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The increase in infections resistant to the existing antimicrobial medicines has become a topic of concern for health professionals, policy makers and publics across the globe; however, among the public there is a sense that this is an issue beyond their control. Research has shown that the news media can have a significant role to play in the public's understanding of science and medicine. In this article, we respond to a call by research councils in the United Kingdom to study antibiotic or antimicrobial resistance as a social phenomenon by providing a linguistic analysis of reporting on this issue in the UK press. We combine transitivity analysis with a social representations framework to determine who and what the social actors are in discussions of antimicrobial resistance in the UK press (2010-2015), as well as which of those social actors are characterised as having agency in the processes around antimicrobial resistance. Findings show that antibiotics and the infections they are designed to treat are instilled with agency, that there is a tension between allocating responsibility to either doctors-as-prescribers or patients-as-users and collectivisation of the general public as an unspecified 'we': marginalising livestock farming and pharmaceutical industry responsibilities.
Collapse
Affiliation(s)
| | - Rusi Jaspal
- De Montfort University, UK; Åbo Akademi University, Finland
| | | |
Collapse
|
7
|
Singh N, Sit MT, Chung DM, Lopez AA, Weerackoon R, Yeh PJ. How Often Are Antibiotic-Resistant Bacteria Said to "Evolve" in the News? PLoS One 2016; 11:e0150396. [PMID: 26934595 PMCID: PMC4775048 DOI: 10.1371/journal.pone.0150396] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 02/12/2016] [Indexed: 11/23/2022] Open
Abstract
Media plays an important role in informing the general public about scientific ideas. We examine whether the word "evolve," sometimes considered controversial by the general public, is frequently used in the popular press. Specifically, we ask how often articles discussing antibiotic resistance use the word "evolve" (or its lexemes) as opposed to alternative terms such as "emerge" or "develop." We chose the topic of antibiotic resistance because it is a medically important issue; bacterial evolution is a central player in human morbidity and mortality. We focused on the most widely-distributed newspapers written in English in the United States, United Kingdom, Canada, India, and Australia. We examined all articles that focused primarily on the evolution of antibiotic resistance, were published in 2014 or earlier, and were accessible in online archives, for a total of 1639 articles. The total years examined per newspaper ranged from 5 to 37 years with a median of 27 years, and the overall range was 1978-2014. We quantified how many articles included the term "evolve" and analyzed how this varied with newspaper, country, and time. We found that an overall rate of 18% of articles used the term "evolve" but with significant variation among countries. Newspapers in the United Kingdom had the highest rate (24%), more than double of those in India (9%), the country with the lowest rate. These frequencies were lower than those found in scientific papers from both evolutionary journals and biomedical journals. There were no statistically significant changes in frequency and no trends when "evolve" usage was compared against variables such as newspaper circulation, liberal/conservative bias, time, and state evolution acceptance in U.S. newspapers. This study highlights the globally low usage of the word "evolve" in the popular press. We suggest this low usage may affect public understanding and acceptance of evolutionary concepts.
Collapse
Affiliation(s)
- Nina Singh
- Department of Ecology and Evolutionary Biology, University of California Los Angeles, Los Angeles, California, United States of America
| | - Matthew T. Sit
- Department of Ecology and Evolutionary Biology, University of California Los Angeles, Los Angeles, California, United States of America
| | - Deanna M. Chung
- Department of Ecology and Evolutionary Biology, University of California Los Angeles, Los Angeles, California, United States of America
| | - Ana A. Lopez
- Department of Ecology and Evolutionary Biology, University of California Los Angeles, Los Angeles, California, United States of America
| | - Ranil Weerackoon
- Department of Statistics, University of Nebraska Lincoln, Lincoln, Nebraska, United States of America
| | - Pamela J. Yeh
- Department of Ecology and Evolutionary Biology, University of California Los Angeles, Los Angeles, California, United States of America
| |
Collapse
|
8
|
Evans CT, Hill JN, Guihan M, Chin A, Goldstein B, Richardson MSA, Anderson V, Risa K, Kellie S, Cameron KA. Implementing a patient education intervention about Methicillin-resistant Staphylococcus aureus prevention and effect on knowledge and behavior in veterans with spinal cord injuries and disorders: a pilot randomized controlled trial. J Spinal Cord Med 2014; 37:152-61. [PMID: 24090538 PMCID: PMC4066423 DOI: 10.1179/2045772313y.0000000153] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVES To assess the feasibility and effect of a nurse-administered patient educational intervention about Methicillin-resistant Staphylococcus aureus (MRSA) prevention on knowledge and behavior of Veterans with spinal cord injuries and disorders (SCI/D). DESIGN Blinded, block-randomized controlled pilot trial. SETTING Two Department of Veterans Affairs (VA) SCI Centers. PARTICIPANTS Veterans were recruited March-September 2010 through referral by a healthcare provider from inpatient, outpatient, and residential care settings. INTERVENTION Thirty participants were randomized to the nurse-administered intervention and 31 to the usual care group. The intervention included a brochure and tools to assist nurses in conducting the education. OUTCOME MEASURES Pre- and post-intervention measurement of knowledge and behaviors related to MRSA and prevention strategies and feasibility measures related to implementation. RESULTS Participants were primarily male (95.1%), white (63.9%), with tetraplegia (63.9%) and mean age and duration of injury of 64.3 and 20.5 years, respectively. The intervention groups mean knowledge score significantly increased between pre- and post-test (mean change score = 1.70, 95% confidence interval, CI 0.25-3.15) while the usual care groups score did not significantly change (mean change score = 1.45, 95% CI -0.08-2.98). However, the mean knowledge change between intervention and usual care groups was not significantly different (P = 0.81). Overall behavior scores did not significantly differ between treatment groups; however, the intervention group was more likely to report intentions to clean hands (90.0% vs. 64.5%, P = 0.03) and asking providers about MRSA status (46.7% vs. 16.1%, P = 0.01). Nurse educators reported that the quality of the intervention was high and could be implemented in clinical care. CONCLUSIONS A targeted educational strategy is feasible to implement in SCI/D clinical practices and may improve some participants' knowledge about MRSA and increase intentions to improve hand hygiene and engagement with providers about their MRSA status.
Collapse
Affiliation(s)
- Charlesnika T. Evans
- Correspondence to: Charlesnika T. Evans, Department of Veterans Affairs, Center for Management of Complex Chronic Care (CMC3), Spinal Cord Injury Quality Enhancement Research Initiative (SCI QUERI), Edward Hines Jr. VA Hospital, 5th & Roosevelt Road, 151H, Hines, IL 60141, USA.
| | - Jennifer N. Hill
- Department of Veterans Affairs, Center for Management of Complex Chronic Care (CMC3), Spinal Cord Injury Quality Enhancement Research Initiative (SCI QUERI), Edward Hines Jr. VA Hospital, Hines, IL, USA
| | | | | | - Barry Goldstein
- Department of Rehabilitation Medicine Seattle, VACO/Patient Care Services, Spinal Cord Injury/Disorders Services, University of Washington, WA, USA
| | | | | | - Kathleen Risa
- Department of Veterans Affairs MRSA Program Office, Office of Patient Care Services, Pittsburgh, PA, USA
| | - Susan Kellie
- Infectious Disease Service, New Mexico VA Health Care System, Albuquerque, NM, USA
| | - Kenzie A. Cameron
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| |
Collapse
|
9
|
Burnett E, Johnston B, Kearney N, Corlett J, MacGillivray S. Understanding factors that impact on public and patient's risk perceptions and responses toward Clostridium difficile and other health care-associated infections: a structured literature review. Am J Infect Control 2013. [PMID: 23199700 DOI: 10.1016/j.ajic.2012.05.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Clostridium difficile is the most common health care-associated infection and a major cause of death and increased morbidity. It is vital that patients and the public are provided with the right information and communication to assist them to understand their role in preventative measures. Successful implementation of communication and management strategies hinges on individuals' risk perceptions. METHODS We performed a structured literature review to examine the evidence regarding public and patients' risk perceptions and responses toward Clostridium difficile and other health care-associated infections. Fourteen studies were included. RESULTS Only 1 study was specific to Clostridium difficile, and 7 were related to other health care-associated infections. Many reported limited understanding of the technical issues of the infection, concerns of transmission to family and friends, inadequate information available, and distrust. The media were one of the main sources of information. Both emotional and physical responses highlighted the level of confusion, fear, anxiety, and anger. CONCLUSION Empirical research of risk perceptions toward Clostridium difficile is limited. Without well-researched studies examining risk perceptions and responses, there is a danger of developing and implementing communication and management strategies that do not meet the needs of our patients or the public.
Collapse
|
10
|
Burnett E, Kearney N, Johnston B, Corlett J, MacGillivray S. Understanding factors that impact on health care professionals' risk perceptions and responses toward Clostridium difficile and meticillin-resistant Staphylococcus aureus: a structured literature review. Am J Infect Control 2013; 41:394-400. [PMID: 23489738 DOI: 10.1016/j.ajic.2012.12.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Revised: 12/02/2012] [Accepted: 12/03/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Clostridium difficile is the most common health care-associated infection. Despite considerable efforts to prevent and manage C difficile, poor clinical practice and nonadherence to policy continues to compromise patient safety. Risk perception research is essential in gaining understanding about how health care professionals respond. METHODS A structured literature review examined empirical evidence regarding health care professionals' risk perceptions and responses toward C difficile. Because of limited evidence available, the review was extended to include other health care-associated infections. Only studies related to methicillin-resistant Staphylococcus aureus (MRSA) could be identified. RESULTS Eleven studies were included. Four were specific to C difficile and 7 to MRSA. All studies found that technical understanding of C difficile was poor and that staff were concerned about risks to patients and themselves. Technical understanding for MRSA, however, was good, and staff were less concerned about their own health. Information provision was perceived to be inadequate and untrustworthy, which included the media. Practice in most studies was poor. CONCLUSION There is a need to build on the efforts of risk perception research from other disciplines to understand how health care professionals think and make decisions about C difficile. This can help inform the development of effective management and communication strategies to maximize the quality of care provided.
Collapse
|
11
|
Hill JN, Evans CT, Cameron KA, Rogers TJ, Risa K, Kellie S, Richardson MS, Anderson V, Goldstein B, Guihan M. Patient and provider perspectives on methicillin-resistant Staphylococcus aureus: a qualitative assessment of knowledge, beliefs, and behavior. J Spinal Cord Med 2013; 36:82-90. [PMID: 23809521 PMCID: PMC3595972 DOI: 10.1179/2045772312y.0000000073] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) is a frequent cause of healthcare-associated infection. Individuals with spinal cord injuries and disorders (SCI/D) are at high risk of MRSA colonization and infection. The Department of Veterans Affairs (VA) released guidelines to prevent the spread of MRSA in Veterans with SCI/D; however, available patient educational materials did not address the unique issues for this population. OBJECTIVE To assess perceptions of SCI/D providers and Veterans with SCI/D regarding MRSA and their educational needs about MRSA prevention, with an ultimate goal of developing patient educational materials that address the issues unique to SCI/D. METHODS Purposive samples of SCI/D providers (six groups) and Veterans with SCI/D (one group) at two VA facilities participated in 60-90-minute focus group sessions. Qualitative data were analyzed using latent content and constant comparative techniques to identify focal themes. PARTICIPANTS Thirty-three providers (physicians and nurses working in inpatient, outpatient, and homecare settings) and eight Veterans participated. RESULTS Three overarching themes emerged from the analysis: knowledge about MRSA, hand hygiene, and barriers to educating Veterans with SCI/D. CONCLUSIONS SCI/D providers and Veterans with SCI/D identified gaps in general MRSA knowledge, gaps in knowledge of good hand hygiene practices and of required frequency of hand hygiene, and barriers to educating Veterans with SCI/D during inpatient stays. Future educational materials and strategies should address these gaps.
Collapse
Affiliation(s)
- Jennifer N. Hill
- Department of Veterans Affairs, Center for Management of Complex Chronic Care (CMC3\Spinal Cord Injury Quality Enhancement Research Initiative (SCI QUERI), Edward Hines Jr VA Hospital, Hines, IL, USA,Correspondence to: Jennifer N. Hill, Department of Veterans Affairs, Center for Management of Complex Chronic Care (CMC/Spinal Cord Injury Quality Enhancement Research Initiative (SCI QUERI), Edward Hines Jr VA Hospital, Hines, IL, Illinois 60141, USA.
| | - Charlesnika T. Evans
- Department of Veterans Affairs, Center for Management of Complex Chronic Care (CMC3\Spinal Cord Injury Quality Enhancement Research Initiative (SCI QUERI), Edward Hines Jr VA Hospital, Hines, IL, USA; and Institute for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Kenzie A. Cameron
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Thea J. Rogers
- Department of Veterans Affairs, Center for Management of Complex Chronic Care (CMC3\Spinal Cord Injury Quality Enhancement Research Initiative (SCI QUERI), Edward Hines Jr VA Hospital, Hines, IL, USA
| | - Kathleen Risa
- Department of Veterans Affairs MRSA Program Office, Office of Patient Care Services, Pittsburgh, PA, USA
| | - Susan Kellie
- Infectious Disease Service, New Mexico VA Health Care System, Albuquerque, New Mexico, USA
| | | | - Vicki Anderson
- Medical College of Wisconsin, Spinal Cord Injury Service, Clement J. Zablocki VA Medical Center, Milwaukee, WI, USA
| | - Barry Goldstein
- VACO/Office of Patient Care Services, VA Spinal Cord Injury and Disorders Services, Seattle, WA, USA
| | - Marylou Guihan
- Department of Veterans Affairs, Center for Management of Complex Chronic Care (CMC3\Spinal Cord Injury Quality Enhancement Research Initiative (SCI QUERI), Edward Hines Jr VA Hospital, Hines, IL, USA; and Institute for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| |
Collapse
|
12
|
Whatley V, Jackson L, Taylor J. Improving public perceptions around cleanliness and health care associated infection in hospitals (service improvement). J Infect Prev 2012. [DOI: 10.1177/1757177412462047] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A qualitative study was undertaken to understand public perceptions of hospital cleanliness and how this might be improved following national initiatives to reduce infection rates and invest in domestic services. Eleven focus groups were held across the West Midlands. Results demonstrated that perceptions are attained from a variety of sources. For patients and visitors the things they see, hear, smell and taste in hospitals and health services shaped their perceptions of cleanliness. For the public the media, friends and family are important. Key factors for attention include: ensuring hospital floors, walls, ceilings, doors and toilets are kept clean, tidy, and unstained; an absence of strong odours; patients have the opportunity for regular baths/showers; staff have clean hands and uniforms, have short, clean finger nails and hair tied back; and eye-catching material on why cleanliness is important as well as what people need to do. Participants were generally unaware of the symptoms of MRSA, Clostridium difficile or Norovirus. The results of the study suggest that attention needs to be focussed on developing effective communication strategies. This will only be possible by adopting a multifaceted approach and enabling collaborative working between infection control staff, communications teams and other frontline staff.
Collapse
Affiliation(s)
- Vanessa Whatley
- Lead Nurse Infection Prevention Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
| | | | | |
Collapse
|
13
|
Rohde RE, Ross-Gordon J. MRSA model of learning and adaptation: a qualitative study among the general public. BMC Health Serv Res 2012; 12:88. [PMID: 22469420 PMCID: PMC3342089 DOI: 10.1186/1472-6963-12-88] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Accepted: 04/02/2012] [Indexed: 11/25/2022] Open
Abstract
Background More people in the US now die from Methicillin Resistant Staphylococcus aureus (MRSA) infections than from HIV/AIDS. Often acquired in healthcare facilities or during healthcare procedures, the extremely high incidence of MRSA infections and the dangerously low levels of literacy regarding antibiotic resistance in the general public are on a collision course. Traditional medical approaches to infection control and the conventional attitude healthcare practitioners adopt toward public education are no longer adequate to avoid this collision. This study helps us understand how people acquire and process new information and then adapt behaviours based on learning. Methods Using constructivist theory, semi-structured face-to-face and phone interviews were conducted to gather pertinent data. This allowed participants to tell their stories so their experiences could deepen our understanding of this crucial health issue. Interview transcripts were analysed using grounded theory and sensitizing concepts. Results Our findings were classified into two main categories, each of which in turn included three subthemes. First, in the category of Learning, we identified how individuals used their Experiences with MRSA, to answer the questions: What was learned? and, How did learning occur? The second category, Adaptation gave us insights into Self-reliance, Reliance on others, and Reflections on the MRSA journey. Conclusions This study underscores the critical importance of educational programs for patients, and improved continuing education for healthcare providers. Five specific results of this study can reduce the vacuum that currently exists between the knowledge and information available to healthcare professionals, and how that information is conveyed to the public. These points include: 1) a common model of MRSA learning and adaptation; 2) the self-directed nature of adult learning; 3) the focus on general MRSA information, care and prevention, and antibiotic resistance; 4) the interconnected nature of adaptation; and, 5) the need for a consistent step by step plan to deal with MRSA provided at the time of diagnosis.
Collapse
Affiliation(s)
- Rodney E Rohde
- Clinical Laboratory Science Program, College of Health Professions, Texas State University-San Marcos, Texas, USA.
| | | |
Collapse
|
14
|
Joffe H, Washer P, Solberg C. Public engagement with emerging infectious disease: The case of MRSA in Britain. Psychol Health 2011; 26:667-83. [DOI: 10.1080/08870441003763238] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
15
|
Morrow E, Griffiths P, Rao GG, Flaxman D. "Somebody else's problem?" Staff perceptions of the sources and control of meticillin-resistant Staphylococcus aureus. Am J Infect Control 2011; 39:284-91. [PMID: 21030114 DOI: 10.1016/j.ajic.2010.06.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Revised: 06/03/2010] [Accepted: 06/03/2010] [Indexed: 11/25/2022]
Abstract
BACKGROUND Meticillin-resistant Staphylococcus aureus (MRSA) is endemic within the United Kingdom health care sector. Recent campaigns to reduce health care-associated infection have rested on increasing staff accountability and ownership of the problem and its solutions. However, the existence of reservoirs of colonization in the community now creates ambiguity about sources, which may undermine preventative strategies. METHODS The theoretical framework of causal attribution was applied to explore staff biases in perceptions and effects on infection control behaviors on both sides of the hospital/care home interface. Forty-four staff from 1 acute care hospital and 53 staff from 6 care homes estimated prevalence, risk, and sources of MRSA. Focus groups (6 care home and 8 hospital) were used to elicit group perceptions. RESULTS Staff tended to attribute the causes of MRSA to external (not self) human factors including patient risk factors and poor infection control practices of others. Teams tend to attribute their "successes" in infection control to dispositional attributions (good team policy and performance) and attribute "lapses" to situational factors (client group, patient movement, work pressures). CONCLUSION Variations in information needs, ownership, and infection control practices could be addressed by better interorganizational working and support for staff teams to assess their own responses to the problem.
Collapse
|
16
|
Andersson H, Lindholm C, Fossum B. MRSA - global threat and personal disaster: patients' experiences. Int Nurs Rev 2010; 58:47-53. [DOI: 10.1111/j.1466-7657.2010.00833.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
17
|
A staff questionnaire study of MRSA infection on ENT and general surgical wards. Eur Arch Otorhinolaryngol 2010; 267:1455-9. [DOI: 10.1007/s00405-010-1221-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2009] [Accepted: 02/16/2010] [Indexed: 11/26/2022]
|
18
|
Fletcher M. Hand hygiene and infection in hospitals: what do the public know; what should the public know? J Hosp Infect 2009; 73:397-9. [DOI: 10.1016/j.jhin.2009.06.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2009] [Accepted: 06/22/2009] [Indexed: 11/16/2022]
|
19
|
Lindberg M, Carlsson M, Högman M, Skytt B. Suffering from meticillin-resistant Staphylococcus aureus: experiences and understandings of colonisation. J Hosp Infect 2009; 73:271-7. [DOI: 10.1016/j.jhin.2009.07.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2009] [Accepted: 07/05/2009] [Indexed: 10/20/2022]
|
20
|
Brady RRW, McDermott C, Cameron F, Graham C, Gibb AP. UK healthcare workers' knowledge of meticillin-resistant Staphylococcus aureus practice guidelines; a questionnaire study. J Hosp Infect 2009; 73:264-70. [PMID: 19783068 DOI: 10.1016/j.jhin.2009.07.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2009] [Accepted: 07/14/2009] [Indexed: 11/30/2022]
Abstract
Effective infection control practice requires knowledge of and adherence to contemporary infection control guidelines. Utilising a novel questionnaire tool, we evaluated knowledge of recently published guidelines on meticillin-resistant Staphylococcus aureus (MRSA) precautions in a number of relevant healthcare worker (HCW) populations. The questionnaire was developed from national UK MRSA practice guidelines and consisted of 10 'true or false' statements. The questionnaire was utilised to assess knowledge in 293 participants from HCW and control populations. The participants included 188 doctors attending the British Medical Association's Annual Representatives Meeting, 52 trainee surgeons attending the Association of Surgeons in Training annual conference, 30 members of a non-clinical control population and 23 infection control nurses (ICNs). The mean (SD) score for knowledge levels obtained from doctors was 6.6 (1.68), for non-clinical control population was 4.7 (1.8) and for ICNs, 8.4 (1.12). There were significant differences in knowledge levels between different population groups (P<0.001), UK employment region of the participant (P=0.01) and the doctors' medical specialty (P=0.02). Career seniority and gender of the participant were not significantly associated with differences in levels of knowledge. This questionnaire study evaluates a novel discriminatory questionnaire tool which differentiates knowledge levels of MRSA practice guidelines among a non-clinical population, HCWs and specialist infection control staff, thus providing a means for the rapid assessment of MRSA educational interventions. We identify demographics within HCW target populations which are associated with low levels of such knowledge. Consideration towards revising current HCW educational programmes to improve knowledge and best practice in MRSA prevention is required.
Collapse
Affiliation(s)
- R R W Brady
- Academic Coloproctology, University of Edinburgh, UK.
| | | | | | | | | |
Collapse
|
21
|
Patients and the public: knowledge, sources of information and perceptions about healthcare-associated infection. J Hosp Infect 2009; 72:1-8. [DOI: 10.1016/j.jhin.2009.01.024] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2009] [Accepted: 01/23/2009] [Indexed: 11/20/2022]
|
22
|
Le Sage S, McGee M, Emed JD. Knowledge of Venous Thromboembolism (VTE) prevention among hospitalized patients. JOURNAL OF VASCULAR NURSING 2008; 26:109-17. [DOI: 10.1016/j.jvn.2008.09.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2008] [Revised: 09/28/2008] [Accepted: 09/29/2008] [Indexed: 10/21/2022]
|
23
|
Easton PM, Marwick CA, Williams FLR, Stringer K, McCowan C, Davey P, Nathwani D. A survey on public knowledge and perceptions of methicillin-resistant Staphylococcus aureus. J Antimicrob Chemother 2008; 63:209-14. [DOI: 10.1093/jac/dkn447] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
24
|
Infection control knowledge, attitude, and practice among Nepalese health care workers. Am J Infect Control 2008; 36:595-7. [PMID: 18926315 DOI: 10.1016/j.ajic.2007.10.026] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2007] [Revised: 10/05/2007] [Accepted: 10/05/2007] [Indexed: 11/24/2022]
Abstract
This study was designed to assess the knowledge, attitudes, and infection control practices among Nepalese health care workers (HCWs). The study comprised a questionnaire survey of 324 staff from acute care hospitals in Kathmandu, Nepal. A total of 158 doctors and 166 nurses participated, 27% of whom had received infection control training. Only 16%, 14%, and 0.3% of the respondents achieved maximum scores for knowledge, attitude, and practice items, respectively. Staff had good knowledge and positive attitude toward most aspects of infection control, although only half had heard of methicillin-resistant Staphylococcus aureus. Logistic regression revealed that profession, age, and having studied abroad significantly predicted markers of infection control knowledge, attitudes, and practice. This is the first survey of infection control practice among Nepalese HCWs and provides useful baseline data by professional group. There is ample opportunity for improvement in current practice, which should be recognized by hospital managers and Nepalese health authorities.
Collapse
|
25
|
Brooks L, Shaw A, Sharp D, Hay AD. Towards a better understanding of patients' perspectives of antibiotic resistance and MRSA: a qualitative study. Fam Pract 2008; 25:341-8. [PMID: 18647956 DOI: 10.1093/fampra/cmn037] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Patients' expectations for antibiotics are known to influence prescribing, but little is known about patients' understanding of, and attitudes to, antibiotic resistance and whether these could modify treatment expectations. OBJECTIVE To explore primary care patients' perspectives on antibiotic resistance and methicillin-resistant Staphylococcus aureus (MRSA) and understand how these could modify expectations for antibiotics. METHODS A qualitative investigation using focus groups and semi-structured interviews with patients purposely sampled from low, intermediate and high antibiotic consumption groups from socio-economically contrasting general practices. RESULTS There was uncertainty concerning the nature and implications of antibiotic resistance for both individuals and the wider community. While some patients viewed antibiotic resistance as a problem for society, most did not see it as something that would affect them personally. Many thought that science would provide the solution through the development of new drugs. Responsibility for antibiotic resistance was mostly attributed to 'other' patients and GPs who had respectively overused and overprescribed antibiotics in the past. As MRSA was mainly seen as a hospital-based problem, blame was largely directed at hospital management and, to a lesser degree, doctors, nurses and cleaners. Concerns about antibiotic resistance were not regarded as a reason to modify individual use of antibiotics. CONCLUSIONS Many primary care patients are unaware of what antibiotic resistance is and how it arises. The causes of, and responsibility for, antibiotic resistance are usually attributed to external rather than personal factors and patients perceive that its solutions are outside of their control.
Collapse
Affiliation(s)
- Lauren Brooks
- Keele University Medical School, Keele University, Keele, Staffordshire, UK
| | | | | | | |
Collapse
|
26
|
Abstract
BACKGROUND Bacteremia is a major pediatric health care problem despite the availability of new modalities in the management of this disease. The aim of the present study was to determine the incidence and pattern of bacteremia in pediatric group at a tertiary hospital in Riyadh, SaudiArabia. METHODS This retrospective study was conducted at the Department of Pediatrics, College of Medicine, King Khalid University Hospital, Riyadh in the period of January 2003 to January 2005. Positive culture was found in 259 patients aged below 15 years with a total of 8244 admissions in the period. RESULTS The highest incidence of bacteremia was found in patients aged less than 1 year (57.9%), and the majority of patients (30.5%) were infants aged less than 1 month. Staphylococcus aureus was the most common isolated pathogen (18.7%). Prematurity was associated with 13.2% of the cases, and respiratory tract infection (10.1%) and fever (76.1%) were chief complaints. CONCLUSIONS Staphylococcus aureus is the most common isolated pathogen. The most common primary infections are respiratory tract infection and septic meningitis. Klebsiellapneumoniae and E. coli are the most common isolated Gram-negative organisms.
Collapse
Affiliation(s)
- Fahad Abdullah Al-Zamil
- Department of Pediatrics, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia.
| |
Collapse
|
27
|
Hawkings NJ, Wood F, Butler CC. Public attitudes towards bacterial resistance: a qualitative study. J Antimicrob Chemother 2007; 59:1155-60. [PMID: 17449888 DOI: 10.1093/jac/dkm103] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Behaviour of members of the public contributes to bacterial resistance. For behavioural change to occur, individuals need to perceive the issue as important to them and feel able to make a valuable contribution. Public campaigns have, so far, not been informed by detailed understanding of public attitudes to the problem. We therefore set out to explore the attitudes of members of the public to bacterial resistance. METHODS A qualitative grounded theory interview study was undertaken. A purposive maximum variation sample included 32 (70%) women and 14 (30%) men, aged from 18 to 89 years, from areas of high, average and low deprivation. RESULTS Participants were uncertain about bacterial resistance and their explanations were generally incongruent with prevailing biomedical concepts. Perceived importance and personal threat were low. The media was the main information source and it left the impression that dirty hospitals are the main cause. Some participants dreaded hospitalization because they feared resistant infections. Few recognized resistant infections as a problem in the community. Less than a quarter indicated that they could positively influence the situation by expecting antibiotic prescriptions less often, or taking antibiotics according to instructions, and even fewer through their own hand washing behaviour. CONCLUSIONS Although members of the public can contribute to containing bacterial resistance, most do not feel that they have a personal role in either the problem or its solution. Campaigns should identify bacterial resistance as both a hospital and a community problem that individuals have the power to influence through specific actions.
Collapse
Affiliation(s)
- Nancy J Hawkings
- Centre for Health Sciences Research, Department of Primary Care and Public Health, Cardiff University, 3rd Floor, Neuadd Meirionnydd, Heath Park, Cardiff, UK.
| | | | | |
Collapse
|