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MRSA-colonized persons’ and healthcare personnel's experiences of patient-professional interactions in and responsibilities for infection prevention in Sweden
University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences. Department of Public Health and Caring Sciences, Uppsala University; Centre for Research and Development, Uppsala University/County Council of Gävleborg.
University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences. Department of Public Health and Caring Sciences, Uppsala University.
University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences. Department of Public Health and Caring Sciences, Uppsala University.ORCID iD: 0000-0002-1495-4943
2014 (English)In: Journal of Infection and Public Health, ISSN 1876-0341, Vol. 7, no 5, 427-435 p.Article in journal (Refereed) Published
Abstract [en]

Background: Patient-professional interactions and adherence to infection control measures are central to the quality of care and patient safety in healthcare. Persons colonized with methicillin-resistant Staphylococcus aureus (MRSA) describe insufficient support and unprofessional behavior among healthcare personnel. Methods: A descriptive qualitative study was conducted to investigate managers', physicians', registered nurses' and MRSA-colonized persons' experiences of patient-professional interactions in relation to and responsibilities for infection prevention in the care of colonized patients. Five persons with MRSA colonization and 20 healthcare personnel employed within infection, hematology, nephrology or primary healthcare settings participated. The data were collected using open-ended semi-structured individual interviews with the MRSA-colonized persons and semi-structured focus group interviews with the healthcare personnel. Results: The participants perceived MRSA as an indefinable threat and described that the responsibility for infection prevention is important, but such adherence was a neglected and negotiable issue. The described actions that were acknowledged as unprofessional and inappropriate adherence to infection prevention resulted in stigmatized patients. Conclusion: Colonized persons' and healthcare personnel's understanding of MRSA determines whether the personnel's behavior is perceived as proper or improper. Individual responsibility for patient-professional interactions in relation to MRSA colonization and adherence to infection control measures should be more stringent.

Place, publisher, year, edition, pages
2014. Vol. 7, no 5, 427-435 p.
Keyword [en]
Infection prevention, MRSA, Patient-professional interaction, Responsibility
National Category
Nursing Infectious Medicine
Identifiers
URN: urn:nbn:se:hig:diva-18433DOI: 10.1016/j.jiph.2014.02.004ISI: 000354964000009PubMedID: 24888790Scopus ID: 2-s2.0-84926247521OAI: oai:DiVA.org:hig-18433DiVA: diva2:770261
Available from: 2014-12-10 Created: 2014-12-10 Last updated: 2015-09-22Bibliographically approved
In thesis
1. Methicillin-resistant Staphylococcus aureus (MRSA) an Unclear and Untoward Issue: Patient-Professional Interactions, Experiences, Attitudes and Responsibility
Open this publication in new window or tab >>Methicillin-resistant Staphylococcus aureus (MRSA) an Unclear and Untoward Issue: Patient-Professional Interactions, Experiences, Attitudes and Responsibility
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of the present thesis was to investigate experiences of living with multidrug-resistant bacteria (MDRB), using methicillin-resistant Staphylococcus aureus (MRSA) colonization as an illustration, and to develop and validate a tool to describe healthcare personnel’s attitudes towards patients with MDRB. A further objective was to study MRSA-colonized persons’ and healthcare personnel’s experiences of patient-professional interactions and responsibilities for infection prevention.

Four empirical studies were conducted. A total of 18 MRSA-colonized persons and 20 healthcare personnel were interviewed regarding their experiences, and a total of 726 RNs responded the MDRB Attitude Questionnaire.

The findings revealed the difficulties associated with living with MRSA colonization, which was described as something uncertain, and as an indefinable threat that has to be managed in both everyday life and in contacts with healthcare. Interactions with healthcare personnel were described as unprofessional owing to personnel’s inappropriate behaviour and insufficient information provision. According to the personnel, achieving adequate patient-professional interactions required having knowledge and experiences of MRSA. They also experienced difficulties in providing tailored information to patients. The MRSA-colonized persons described their unwanted responsibility to inform healthcare personnel about the colonization, but also felt responsible for limiting the spread of infection to others. Furthermore, responsibility for infection control was regarded as shared between healthcare personnel and patients. The personnel described such responsibility as a natural part of their daily work, although it was not always easy to adhere to hygiene precautions. The MRSA-colonized persons felt that healthcare personnel have insufficient knowledge of the bacteria and of hygiene precautions. The MDRB Attitude Questionnaire showed that registered nurses do have knowledge deficiencies. The MDRB Attitude Questionnaire has adequate psychometric properties.

In conclusion, MRSA colonization constitutes a psychological strain for carriers, and interactions with healthcare personnel resulted in feelings of stigmatization. The present thesis indicates that there is a need to improve healthcare personnel’s knowledge, behaviour and emotional response in relation to patients with MDRB, in order to ensure patient safety and address patients’ needs. The heads of department is responsible for such improvements, and the MDRB Attitude Questionnaire is useful in identifying areas in need for improvement.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2012. 74 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 741
Keyword
Attitudes of health personnel, colonization, hygiene, infection control, mixed-methods approach, MRSA, nursing care, patient-professional interaction, quality of healthcare, responsibility, The MDRB Attitude Questionnaire
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-18925 (URN)978-91-554-8273-2 (ISBN)
Public defence
2012-03-27, Universitetshuset, sal IX, Biskopsgatan 3, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2015-02-05 Created: 2015-02-04 Last updated: 2015-09-22Bibliographically approved

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