J Korean Acad Nurs.  2009 Apr;39(2):186-197. 10.4040/jkan.2009.39.2.186.

Hospital Nurses' Knowledge and Compliance on Multidrug-resistant Organism Infection Control Guideline

Affiliations
  • 1Department of Nursing, Dong-A University, Busan, Korea. jykang@dau.ac.kr
  • 2Dong-A University Medical Center, Busan, Korea.
  • 3Department of Nursing, Namseoul University, Cheonan, Korea.

Abstract

PURPOSE
This study was done to investigate nurses' knowledge of, and compliance with the multidrug-resistant organism (MDRO) infection control guidelines. METHODS: A survey questionnaire was developed based on the institutional and national guidelines and was administered to a convenience sample of 306 nurses in a university hospital. RESULTS: The mean score for knowledge was 33.87 (percentage of correct answers: 82.61%). The percentages of correct answers for basic concepts, route of transmission, hand washing/protective devices and environment management were 74.27%, 94.29%, 92.90% and 75.54% respectively. The mean compliance score was 4.15 (range: 1-5). The compliance scores for education, communication, contact precaution, disinfection, surveillance culture, and hand washing were 3.29, 4.05, 4.20, 4.50, 4.40 and 4.48 respectively. Nurses indicated "lack of time (30.06%)", "lack of means (10.78%)" and "lack of knowledge (9.48%)" as reasons for noncompliance. CONCLUSION: While most educational programs have focused on hand washing or use of protective devices to prevent transmission of MDRO in acute care settings, hospital nurses' knowledge of the basic concepts of MDRO and environmental management has remained insufficient. Nurses are relatively non-compliant to the guidelines in the areas of education (staff, patient, family) and communication. Comprehensive educational programs are needed to decrease hospital infection rates and to improve the health of patients.

Keyword

Infection control; Knowledge; Compliance; Education

MeSH Terms

Adult
Attitude of Health Personnel
*Drug Resistance, Multiple, Bacterial
Female
Guideline Adherence
*Health Knowledge, Attitudes, Practice
Hospitals, University
Humans
Infection Control/methods/*standards
Nursing Staff, Hospital/education/*psychology
Practice Guidelines as Topic
Questionnaires

Cited by  2 articles

It Is Time to Address the Isolation Policy for Patients Colonized with Vancomycin-resistant Enterococci
Euijin Chang, Hong Bin Kim
Korean J Healthc Assoc Infect Control Prev. 2021;26(1):16-23.    doi: 10.14192/kjicp.2021.26.1.16.

The Factors Influencing Compliance of Multidrug-resistant Organism Infection Control in Intensive Care Units Nurses
Ji Hee Kim, Kyung Hee Lim
Korean J Adult Nurs. 2015;27(3):325-336.    doi: 10.7469/kjan.2015.27.3.325.


Reference

1. Blok H, Troelstra A, Kamp-Hopmans TE, Gigengack-Baars AC, Vandenbroucke-Grauls CM, Weersink AJ, et al. Role of health care workers in outbreaks of methicillin-resistant Staphylococcus aureus: A 10-year evaluation from a Dutch university hospital. Infection Control and Hospital Epidemiology. 2003. 24:679–685.
2. Cheong H, Song J, Eom J, Kim W, Choi S, Choi J, et al. Colonization rate, risk factor for acquisition and genetic diversity of Vancomycin-resistant enterococci (VRE) isolated from rectal culture of patients in intensive care units from ten large hospitals in Korea. Korean Journal of Infectious Disease. 2002. 34:276–284.
3. Clancy M, Graepler A, Wilson M, Douglas I, Johnson J, Price CS. Active screening in high risk units is an effective and cost-avoidant method to reduce the rate of MRSA infection in the hospital. Infection Control and Hospital Epidemiology. 2006. 27:1009–1017.
4. DiazGranados CA, Zimmer SM, Klein M, Jernigan JA. Comparison of mortality associated with vancomycin-resistant and vancomycin-susceptible enterococcal bloodstream infections: A meta-analysis. Clinical Infectious Diseases. 2005. 41:327–333.
5. Dong-A University Medical Center. Guideline for prevention and management of infection. 2008. Busan: Author.
6. Easton PM, Sarma A, Williams FL, Marwick CA, Phillips G, Nathwani D. Infection control and management of MRSA: Assessing the knowledge of staff in an acute hospital setting. Journal of Hospital Infection. 2007. 66:29–33.
7. Engemann JJ, Carmeli Y, Cosgrove SE, Fowler VG, Bronstein MZ, Trivette SL, et al. Adverse clinical and economic outcomes attributable to methicillin resistance among patients with Staphylococcus aureus surgical site infection. Clinical Infectious Diseases. 2003. 36:592–598.
8. Farr B. Doing the right thing (and figuring out what that is). Infection Control and Hospital Epidemiology. 2006. 27:999–1003.
9. Jeong J, Choe M. The effect of hand washing improving programs on the adherence of hand washing and nosocomial infection. Korean Journal of Nosocomial Infection Control. 2004. 9:117–129.
10. Jung M, Yoon S. Analysis on the transmission paths of vancomycin resistant enterococci infection in a health care environment in Korea. Journal of Korean Society of Living Environment System. 2003. 10:125–130.
11. Kim JK, Kim CH, Han SY, Byun HW, Park WJ, Woo HJ, et al. Clinical characteristics in patients with vancomycin-resistant enterococci colonization or infection during 5 years in a private general hospital. Korean Journal of Critical Care Medicine. 2005. 20:54–62.
12. Kim K, Cha K, Lee J, Yoo S, Choi O, Wie S, et al. Knowledge and performance of infection control guidelines. Korean Journal of Nosocomial Infection Control. 2004. 9:139–150.
13. Kim M, Jeong C. The level of the awareness and the compliance on the nosocomial infection control among clinical nurses in the hospital. Korean Journal of Nosocomial Infection Control. 2002. 7:133–141.
14. Kim NC, Choi KO. Effects on nurses' hand washing behavior and reduction of respiratory isolation rate of MRSA of the hand washing education. Journal of Korean Academy of Adult Nursing. 2002. 14:26–33.
15. Kim SO, Cho SH. A study on clinical nurses level of perception of importance, performance and satisfaction in the control of nosocomial infection. Journal of Korean Academy of Nursing. 1997. 27:765–776.
16. Kim YH, Jeon SS, Jeong IS, Chang CH, Kim JH, Huh JA. The effect of hand washing improving program and MRSA carrier screening program on the MRSA infection rates in an intensive care unit. Journal of Korean Acade my of Nursing. 2003. 33:686–692.
17. Klevens RM, Edwards JR, Tenover FC, McDonald LC, Horan T, Gaynes R, et al. Changes in the epidemiology of MRSA in intensive care unit in US hospitals, 1992-2003. Clinical Infectious Diseases. 2006. 42:389–391.
18. Ministry for Health and Welfare. Guideline for prevention and management of hospital infection. 2005. Seoul: Author.
19. Muto CA, Jernigan JA, Ostrowsky BE, Richet HM, Jarvis WR, Boyce JM, et al. SHEA guideline for preventing nosocomial transmission of multidrug-resistant strains of staphylococcus aureus and enterococcus. Infection Control and Hospital Epidemiology. 2003. 24:362–386.
20. National Health Insurance Corporation. Regulations about National Health Insurance Payment for medical treatment. 2008. Seoul: Author;(Rev. July 11, 2008).
21. NNIS. National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2003. American Journal of Infection Control. 2003. 31:481–498.
22. Office of Profession. Mandated training related to infection control. 2008. Retrieved July 2, 2008. from http://www.op.nysed.gov/icmemo.htm.
23. Oh H. National survey on nurses' knowledge of infection control in general hospitals and analysis of variables to impact on their knowledge. Korean Journal of Nosocomial Infection Control. 2005. 10:78–86.
24. Ott M, Shen J, Sherwood S. Evidenced-based practice for control of methicillin-resistant Staphylococcus aureus. AORN Journal. 2005. 81:361–372.
25. Sax H, Perneger T, Hugonnet S, Herrault P, Chraiti MN, Pittet D. Knowledge of standard and isolation precautions in a large teaching hospital. Infection Control and Hospital Epidemiology. 2005. 26:298–304.
26. Shitrit P, Gottsman BS, Katzir M, Kilman A, Ben-Nissan Y, Chowers M. Active surveillance for MRSA decreases the incidence of MRSA bacteremia. Infection Control and Hospital Epidemiology. 2006. 27:1004–1008.
27. Siegal J, Rhinehart E, Jackson M, Chiarello L. HICPAC. Management of multidrug-resistant organisms in healthcare settings, 2006. 2006. Retrieved April 2, 2007. from http://www.cdc.gov/ncidod/dhqp/pdf/ar/mdroGuideline2006.pdf.
28. van Gemerg-Pijnen J, Hendrix MG, van der Palen J, Schellens PJ. Performance of methicillin-resistant Staphylococcus aureus protocols in Dutch hospitals. American Journal of Infection Control. 2005. 33:377–384.
29. Woolf S. Practice guidelines: A new reality in medicine: III. Impact on patient care. Archives in Internal Medicine. 1993. 153:2646–2655.
30. Yoon HS. A survey on the performance of surgical hand scrubs. Journal of Korean Academy of Nursing. 1996. 26:591–604.
Full Text Links
  • JKAN
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr