Nurses Knowledgee Regarding Infection Control (Research Paper Sample)

NURSES KNOWLEDGE REGARDING INFECTION CONTROL
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Nurses Knowledge Regarding Infection Control
Methicillin-Resistant Staphylococcus Aureus (MRSA) is a bacterium that lives in the skin or the nose of around 25-30% of people and is prevalent in many healthcare settings to-day leading to increased morbidity and mortality. Staff nurse play a key role in preventing MRSA, yet there is a lack of research on how education can enhance knowledge regarding MRSA its prevention, control and treatment. This study proposes to measure the knowledge of the registered nurses, who work in surgical units in Saudi Arabia regarding the prevention, control, and treatment of MRSA. An experimental design will be utilised using a pre and post text questionnaire. An educational intervention will be drawn up from the literature focusing on the factors that are crucial in the prevention, control, and treatment of MRSA. This information will also be used to form the questionnaire. 136
Research Aim
The research aim is to determine if an educational intervention could enhance the knowledge base of nurses regarding the prevention, control, and treatment of MRSA in a surgical unit, in Saudi Arabia.
Objectives of the Study
The research has the following objectives:
• To undertake a review of the literature on the role of knowledge, amongst registered
nurses in the prevention, control, and treatment of MRSA
• To identify the knowledge of registered nurses in a surgical unit, in Saudi Arabia
regarding MRSA its prevention, control and treatment
• To determine if an educational intervention could enhance the knowledge base of registered nurses regarding the preventative measures that could be employed to control the spread of MRSA.
• To make recommendations regarding educational programmes, which focus on the
Prevention, control and treatment of MRSA
Research Question
The research question is: what is the level of knowledge of registered nurses regarding MRSA, its prevention, control and treatment within surgical units in Saudi Arabia and how could an educational intervention enhance this knowledge base?
Null Hypothesis
There is no difference between the knowledge of nurses regarding the prevention, control and treatment of MRSA following an educational intervention.
Background
Methicillin-Resistant Staphylococcus Aureus (MRSA) and infection control have been an endemic problem since the 1960s and have become a global issue (Rayner 2003; David & Daum 2010; Azeez-Akaned 2010; Azeez-Akaned 2010). The mortality rates involving MRSA have increased 20-fold during 1993-2002 in England and Wales (Office for National Statistics 2005). MRSA is a bacterium that lives in the skin or inside the nose of around 25-30% of people presenting challenges to nurses and other healthcare professionals regarding its prevention, treatment and control (Jimmy & Snyder 2010). The altitudes, behaviours, knowledge on MRSA and their perceptions regarding MRSA are decisive factors in affecting the outcomes on parties (Storr, Topley & Privett 2005). One of the recommended assessment strategies by Makoni (2002) is establishing a greater understanding of the microorganism sources, the nature of transmission, and the predisposing risk factors. Similarly, May (2000) recommends the adoption of standard infection control precautions. It is acknowledged that staff nurse play a key role in preventing the spread of MRSA, and they should be aware of the practises that will minimise the infection. The literature does demonstrate a lack of research on techniques to control the spread of MSRA. Indeed it has been shown that hand-washing, one of the most fundamental practises to minimise the spread of MSRA is often overlooked by nurses and health care practitioners (Makoni 2002; Topley & Privet 2005). Alongside these McDonald et al, 2003 argue that there is no information on the knowledge of registered nurses regarding MRSA and infection control. This proposal aims to explore if an educational intervention can enhance the knowledge of registered nurses, regarding the prevention, control, and treatment of MRSA.
Research Strategy
The research for the literature was conducted from different databases: Medline, CINAHL, PUBmed, Ovid and ProQuest. The articles were collected in the period from 2000 to 2012, restricted to English only publications. The key terms used for this literature research initially where MRSA and infection control, which yielded in excess of 500 articles. Further use of exclusion criteria such as a registered nurse, knowledge, experience, and surgical unit were applied, which substantially reduced the number of relevant articles. Out of the articles sourced and for the aim of this paper the 6/7 most clear studies will be reviewed.
Literature Review
The literature demonstrates that mortality and morbidity from Healthcare associated infections, including MRSA is increasing (Gastmeier et al. 2006). According to the European Centre for Disease and Control (2009, pp. 16-36), almost 25,000 patients lose their lives across the EU from infections linked with a number of multidrug resistant bacteria. Not only does this bring the traumatic consequences for individuals and their families, it also brings significant financial challenge in a global context (Gemmell et al. 2006; Johnson, Pearson & Duckworth 2005; Tiemersma et al. 2004), consequently, it becomes significant preventative issue that urgently needs to be addressed.
In the UK study Easton et al. (2007), assessed the perceived practice and knowledge of nurses and doctors regarding MRSA in a hospital set up. Data collection was done using a survey method, whereby questionnaires were utilised through group administration as part of the study day. In addition, in order to gain an appropriate sample size, face-to-face interviews were also carried out with personnel from surgical and medical wards over a three-month period using the same questionnaire.
The study yielded 174 interview responses from 87 nurses in medical and surgical units and 87 doctors, and 47 self-completed questionnaires. The questionnaires of which all but one questions were open-ended, sought to assess knowledge regarding the prevention, assessment, and treatment of MRSA. In addition, demographic data was also collected including the post held by the respondent and the time since qualifying. SPSS was used for the data analysis and correct answers were confirmed from the local guidelines and literature. Responses were calculated with 95% confidence levels and differences between the staff groups were compared using a Chi Squared test (P < 0.05). The results demonstrated a considerable variation in responses between doctors and nurses answering correctly. No significant differences were found in interviewers based on the age of the respondents or in the time since qualification. Additionally, there was no significant difference between the interview and the self-completed responses. Perhaps, not surprisingly, the doctors were more knowledgeable about antibiotic choice, whereas nurses demonstrated a higher awareness of infection control issues. The authors suggest that assumptions should not be made about the staff knowledge or awareness of MRSA (Easton et al. 2007).
There are no limitations in the study including the use of a convenience sample, it suggested that the utilisation of the same questionnaire for both professional groups, who have had quite different educational preparations may have influenced the results. Additionally, it could be argued that a lack of knowledge regarding prevention and control measures may be potentially more detrimental to patients, rather than limited knowledge of antibiotics, especially when not all personnel is engaged with prescribing. The situation, therefore, may be more serious than the authors suggest; in the interpretation process care must be taken as a result of interpretation.
Alongside the educational awareness of staff, the literature also suggests that the resources deployed in regard to infection control are paramount. Cunney, et. al. (2006), carried out an infection control survey in 2003, examining the resources used in preventing nosocomial infection such as isolation facilities from 68 acute hospitals in the Republic of Ireland. The study was conducted using a survey technique with questionnaires. An analysis of the data illustrated that there were significant problems in the execution of services, both in terms of the physical and human resource. The authors suggest that issues arise when organisational policies are advisory rather than mandatory; they also suggest the need for European consensus and direction regarding the minimum resources to prevent MRSA (Cunney et. al. 2006). This study demonstrates that while preventative measures have been shown to be successful and cost effective, deployment of resources from treatment to preventative approaches brings challenges.
Conversely Van Gemert-Pijnen et al. (2005), illustrated that protocols while having a crucial role in the prevention of MSRA are not easily utilised by different professional groups. Furthermore, they conclude that protocols should be developed that are attuned to the knowledge and skills of the healthcare worker. This seems to suggest no need for healthcare workers to acquire knowledge on activities being undertaken than following instructions. It's clear that without the knowledge the former may enhance compliance. In their study, they adopted a comprehensive approach in a range of staff groupings including doctors, nurses and cleaning staff. Given that preventative measures need to be embraced and implemented by the complete healthcare team, an acknowledgement of the difference in the knowledge ba...