Effects of Multimodal Strategies on Knowledge and Practices for Prevention of Multidrug-Resistant Organisms Transmission Among Nurses, Semi-Critical Care Unit, Regional Hospital

Authors

  • Prapatsorn Detsri Master of Nursing Science Program in Nursing Care for Patient with Infectious Disease and Infection Control, Faculty of Nursing, Chiang Mai University
  • Nongyao Kasatpibal Faculty of Nursing, Chiang Mai University
  • Nongkran Viseskul Faculty of Nursing, Chiang Mai University

Keywords:

Multidrug-resistant organisms, Multimodal strategies, Knowledge, Practices

Abstract

Multidrug-resistant organisms (MDROs) are a major medical problem in every country, especially in semi-critical care units in Thailand. Knowledge and compliance with guidelines for prevention of MDROs transmission among nurses are important. This quasi-experimental research aimed to examine the effects of multimodal strategies on knowledge and practices for prevention of MDROs transmission. The study sample included 26 nurses in a semi-critical care unit at a regional hospital from November 2018 to February 2019. The multimodal strategies consisted of education, a reminder poster, feedback, and provision of mobile personal protective equipment (PPE). Research instruments included a demographic data questionnaire, a knowledge test, and an observational recording form. Data were analyzed using descriptive statistics, t-test, Chi-squared test, and Fisher exact test.

            After implementing these multimodal strategies, average knowledge scores on prevention of MDROs transmission increased significantly from 14.85 to 18.08 (p< .01) and the overall correct practices in prevention of MDROs transmission increased from 62.42% to 87.13% (p<. 001).   

            This research shows that multimodal strategies can enhance knowledge and practice in prevention of MDROs transmission among nurses in a semi-critical care unit. Application of multimodal strategies may improve knowledge and practices in prevention of MDROs transmission among nurses in other semi-critical care units.

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References

Aboumatar, H., Ristaino, P., Davis, R. O., Thompson, C. B., Maragakis, L., Cosgrove, S., ... Perl, T. M. (2012). Infection prevention promotion program based on the PRECEDE model: Improving hand hygiene behaviors among healthcare personnel. Infection Control and Hospital Epidemiology, 33(2), 144-151. doi: 10.1086/663707

Barnes, S. L., Harris, A. D., Golden, B. L., Wasil, E. A., & Furuno, J. P. (2011). Contribution of interfacility patient movement to overall methicillin-resistant Staphylococcus aureus prevalence levels. Infection Control and Hospital Epidemiology, 32(11), 1073-1078.

Bassetti, M., Poulakou, G., Ruppe, E., Bouza, E., Van Hal, S. J., & Brink, A. (2017). Antimicrobial resistance in the next 30 years, humankind, bugs and drugs: A visionary approach. Intensive Care Medicine, 43(10), 1464-1475.

Bero, L. A., Grilli, R., Grimshaw, J. M., Harvey, E., Oxman, A. D., & Ann, M. (1998). Getting research findings into practice: Closing the gap between research and practice: An overview of systematic reviews of interventions to promote the implementation of research findings. British Medical Journal, 317(7156), 465-468.

Black, S. R., Weaver, K. N., Weinstein, R. A., Hayden, M. K., Lin, M. Y., Lavin, M. A., & Gerber, S. I. (2015). Regional infection control assessment of antibiotic resistance knowledge and practice. Infection Control and Hospital Epidemiology, 36(4), 381-386.

Cai, B., Echols, R., Magee, G., Arjona Ferreira, J. C., Morgan, G., Ariyasu, M., … Nagata, T. D. (2017). Prevalence of carbapenem-resistant gram-negative infections in the United States predominated by Acinetobacter baumannii and Pseudomonas aeruginosa. Open Forum Infections Disease, 4(3), 1-7. doi: 10.1093/ofid/ofx176

Centers for Disease Control and Prevention. (2017). Management of multidrug-resistant organisms in healthcare settings, 2006. Retrieved from: https://www.cdc.gov/infectioncontrol/guidelines/mdro/

De Freitas DalBen, M., Mendes, E. T., Moura, M. L., Rahman, D. A., Peixoto, D., dos Santos, S. A., ... Massad, E. (2016). A model-based strategy to control the spread of carbapenem-resistant Enterobacteriaceae: Simulate and implement. Infection Control and Hospital Epidemiology, 37(11), 1315-1322. doi: 10.1017/ice.2016.168

Flut, D. D. V., & Peterson, T. O. (1994). Contemporary management (3rd ed.). Boston: Houghton Miffin.

Green, L. W., & Kreuter, M. (1991). Health promotion planning an educational and environmental approach (2nd ed.). London: Mayfield.

Jacob, J. T., Klein, G. E., Laxminarayan, R., Beldavs, Z., Lynfield, R., Kallen, A. J., ... Rasheed, K. J. (2013). Vital signs: Carbapenem-resistant Enterobacteriaceae. Morbidity and Mortality Weekly Report, 62(9), 165-169.

Kasatpibal, N., Chittawatanarat, K., Nunngam, N., Kampeerapanya, D., Duangsoy, N., Sroison, U., & Rachakom, C. (in process). Development and promotion of clinical practice guidelines on prevention and control of multidrug-resistant organism transmission in surgical intensive care unit. Faculty of Nursing, Chiang Mai University. (in Thai)

Katherason, S. G., Naing, L., Jaalam, K., Mohamad, N. A. N., Bhojwani, K., Harussani, N. D. S. H., & Ismail, A. (2010). Hand decontamination practices and the appropriate use of gloves in two adult intensive care units in Malaysia. The Journal of Infection in Developing Countries, 4(02), 118-123.

Krakanna,K., Picheansathian, W., & Boonchuang, P. (2010). Effect of knowledge and practice promotional program among nurse on Methicillin-resistant Staphylococcus aureus transmission control in an Intensive care unit. Bulletin of Nosocomial Infection Control Group of Thailand, 20(3), 35-47. (in Thai)

National Antimicrobial Resistance Surveillance Center Thailand. (2018). Situation of antimicrobial resistance 2000 – 2018. (in Thai) Retrieved from: http://narst.dmsc.moph.go.th/data/AMR%202000-2018-12M.pdf

Nithedsilp, W. (2008). Instructional and innovation for learning. Pathum Thani: Skybook. (in Thai)

Onsaard, C., Klunklin, P., & Senaratana, W. (2012). Effects of the prevention and control program for methicillin- resistant Staphylococcus Aureus on knowledge and practices among nurses in neonatal intensive care unit. Nursing Journal, 39(2), 51-65. (in Thai)

Phumart, P., Phodha, T., Thamlikitkul, V., Riewpaiboon, A., Prakongsai, P., & Limwattananon, S. (2012). Health and economic impacts of antimicrobial resistant infections in Thailand: A preliminary study. Journal of Health Systems Research, 6(3), 352-360. (in Thai)

Prevention and infection control committee Prapokklao Hospital. (2017). Report surveillance of hospital-acquired infections. Department prevention and infection control in hospital Prapokklao Hospital. (in Thai)

Seibert, D. J., Speroni, K. G., Oh, K. M., DeVoe, M. C., & Jacobsen, K. H. (2014). Knowledge, perceptions, and practices of methicillin-resistant Staphylococcus aureus transmission prevention among health care workers in acute-care settings. American Journal of Infection Control, 42(3), 254-259. doi: 10.1016/j.ajic.2013.09.005

Shen, L., Wang, X., An, J., An, J., Zhou, N., Sun, L., ... Liu, X. (2017). Implementation of WHO multimodal strategy for improvement of hand hygiene: A quasi-experimental study in a Traditional Chinese Medicine Hospital in Xi’an, China. Antimicrobial Resistance and Infection Control, 6(1), 1-7. doi: 10.1186/s13756-017-0254-4

Thongcharoen, P., Moongtui, W., & Unahalekhaka, A. (2015). Effects of using multifaceted strategic method on practices of healthcare personnel in prevention of multidrug resistant bacterial Infection. Nursing Journal, 42(1), 61-73. (in Thai)

Published

2021-09-20

Issue

Section

Research Article