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  • 1.
    Lindberg, Maria
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science. Department of Public Health and Caring Sciences, Uppsala University; Centre for Research and Development, Uppsala University/County Council of Gävleborg.
    Carlsson, Marianne
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science. Department of Public Health and Caring Sciences, Uppsala University.
    Skytt, Bernice
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science. Department of Public Health and Caring Sciences, Uppsala University.
    MRSA-colonized persons’ and healthcare personnel's experiences of patient-professional interactions in and responsibilities for infection prevention in Sweden2014In: Journal of Infection and Public Health, ISSN 1876-0341, Vol. 7, no 5, p. 427-435Article in journal (Refereed)
    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.

  • 2.
    Lindberg, Maria
    et al.
    Uppsala universitet.
    Lindberg, Magnus
    Uppsala universitet.
    Haemodialysis nurses knowledge about methicillin-resistant Staphylococcus aureus2012In: Journal of renal care, ISSN 1755-6686, Vol. 38, no 2, p. 82-85Article in journal (Refereed)
    Abstract [en]

    Healthcare workers may lack knowledge about antibiotic-resistant bacteria and thereby increase the spread of such organisms. The aim of the present study was to describe the relationship between self-rated knowledge and actual knowledge about methicillin-resistant Staphylococcus aureus (MRSA) among 326 Swedish haemodialysis nurses. Data were collected through a postal questionnaire. The findings suggest that ongoing education about MRSA should be provided to haemodialysis nurses, but also that standardised evaluation of adequate knowledge, skills and competencies' regarding safe practices is warranted. Future research should focus on effective mechanisms to ensure that haemodialysis nurses provide safe MRSA care.

  • 3.
    Lindberg, Maria
    et al.
    Centre for Research and Development, Uppsala University County Council of Gävleborg, Gävle, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Lindberg, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Skytt, Bernice
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Risk behaviours for organism transmission in health care delivery: A two month unstructured observational study2017In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 70, p. 38-45Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Errors in infection control practices risk patient safety. The probability for errors can increase when care practices become more multifaceted. It is therefore fundamental to track risk behaviours and potential errors in various care situations.

    OBJECTIVE: The aim of this study was to describe care situations involving risk behaviours for organism transmission that could lead to subsequent healthcare-associated infections.

    DESIGN & SETTING: Unstructured nonparticipant observations were performed at three medical wards.

    PARTICIPANTS & METHODS: Healthcare personnel (n=27) were shadowed, in total 39h, on randomly selected weekdays between 7:30 am and 12 noon. Content analysis was used to inductively categorize activities into tasks and based on the character into groups. Risk behaviours for organism transmission were deductively classified into types of errors. Multiple response crosstabs procedure was used to visualize the number and proportion of errors in tasks. One-Way ANOVA with Bonferroni post Hoc test was used to determine differences among the three groups of activities.

    RESULTS: The qualitative findings gives an understanding of that risk behaviours for organism transmission goes beyond the five moments of hand hygiene and also includes the handling and placement of materials and equipment. The tasks with the highest percentage of errors were; 'personal hygiene', 'elimination' and 'dressing/wound care'. The most common types of errors in all identified tasks were; 'hand disinfection', 'glove usage', and 'placement of materials'. Significantly more errors (p<0.0001) were observed the more multifaceted (single, combined or interrupted) the activity was.

    CONCLUSION: The numbers and types of errors as well as the character of activities performed in care situations described in this study confirm the need to improve current infection control practices. It is fundamental that healthcare personnel practice good hand hygiene however effective preventive hygiene is complex in healthcare activities due to the multifaceted care situations, especially when activities are interrupted. A deeper understanding of infection control practices that goes beyond the sense of security by means of hand disinfection and use of gloves is needed as materials and surfaces in the care environment might be contaminated and thus pose a risk for organism transmission.

  • 4.
    Lindberg, Maria
    et al.
    Centre for Research and Development, Uppsala University/Country Council of Gävleborg.
    Lindberg, Magnus
    Centre for Research and Development, Uppsala University/Country Council of Gävleborg.
    Skytt, Bernice
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Högman, Marieann
    Centre for Research and Development, Uppsala University/Country Council of Gävleborg.
    Carlsson, Marianne
    Department of Public Health and Caring Sciencies, Uppsla University.
    Attitudes toward patients with multidrug-resistant bacteria: scale development and psychometric evaluation2011In: Journal of Infection Prevention, ISSN 1757-1782, Vol. 12, no 5, p. 196-203Article in journal (Refereed)
    Abstract [en]

    There is a need for validated assessment tools for measuring attitudes towards patients with multidrug- resistant bacteria. Such an assessment tool was developed and psychometrically evaluated in the present study. A literature review and discussions with experts and key informants were used to develop the questionnaire. To ensure item adequacy and interpretability, face validity and pre-tests were performed. Item validity, content validity and internal consistency reliability were evaluated in a non-random sample of 329 hemodialysis nurses. The psychometric properties were satisfactory, indicating good item validity. The content validity revealed three appropriate factors with good internal consistency reliability. The haemodialysis nurses’ knowledge about multidrug-resistant bacteria was not suf. cient, and their intentional behaviour was unsatisfactory with respect to infection control precautions. The multidrug-resistant bacteria Attitude Questionnaire would be a valuable tool, in nursing practice and nursing education, in promoting quality improvements in patient safety with regard to healthcare associated infections.

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