Knowledge, attitudes, and readiness about critical antimicrobial resistant organisms among healthcare workers at colonial war memorial hospital in Fiji: a pre and post intervention study.

IF 4.8 2区 医学 Q1 INFECTIOUS DISEASES
Kirsty Buising, Ravi Naidu, Shammi Prasad, Matthew Richards, Savneel Shivam Kumar, Alvina Lata, Ashlyn Datt, Sisilia Assisi Genaro, Timaima Ratusela, Ilisapeci Nabose, Donna Cameron, Ana Suka, Tracey Young-Sharma, Benjamin P Howden, Aneley Getahun Strobel
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引用次数: 0

Abstract

Background: Gram-negative bacteria resistant to carbapenems are also known as critical antimicrobial resistant organisms. Their emergence at Colonial War Memorial Hospital (CWMH), the largest hospital in Fiji, is a major clinical concern. This study was conducted to determine the knowledge, attitudes, and readiness of healthcare workers (HCW) at CWMH regarding management of patients with infections caused by critical antimicrobial resistant organisms.

Methods: A questionnaire was designed using a Likert scale to assess knowledge, attitudes, and readiness. Two cross-sectional studies were conducted, before and after the implementation of targeted educational activities which were informed by the pre-intervention study findings.

Results: A total of 393 and 420 HCW participated in the pre- and post-intervention studies, respectively. The majority of respondents were female (77.3%) and 18-34 years of age (67%). HCW professional roles included nurses (56.3%), doctors (31.6%), and laboratory personnel (12.2%). In the post-intervention study, significantly more HCW reported having received infection prevention and control (IPC) and antimicrobial resistance education and training (26.8% in pre to 45.5% in post intervention, p < 0.001). The majority of nurses and doctors (> 85% to ≥ 95%) were aware of how AMR organisms spread in healthcare settings and knew the IPC measures to prevent transmission of AMR infections including hand hygiene, standard and transmission-based precautions. Attitudes towards AMR were positive, with 84.2% pre intervention and 84.8% of HCW post intervention expressing their willingness to change their work environment to assist with AMR prevention. Perceived readiness to address the problem showed mixed results. Improvements in laboratory AMR surveillance data availability were noted (29.4-52.4%, p < 0001). Modest improvement in the hospital's capacity for outbreak response (44-51.9%, p = 0.01), and treatment of AMR infections (38.9-44.4%, p = 0.01) was reported.

Conclusions: Our data revealed high levels of staff awareness and knowledge about AMR and IPC. However, readiness for outbreak response and treatment of critical AMR infections requires more attention. Improving AMR prevention and containment in CWMH will likely require sustained and multisectoral interventions with strong administrative commitment.

斐济殖民战争纪念医院医护人员对严重耐抗菌生物的知识、态度和准备情况:干预前后研究。
背景:对碳青霉烯类产生耐药性的革兰氏阴性细菌也被称为临界抗菌药耐药菌。在斐济最大的医院--殖民战争纪念医院(CWMH),耐碳青霉烯类细菌的出现是临床关注的焦点。本研究旨在了解殖民地战争纪念医院医护人员(HCW)在处理由临界抗菌药耐药菌引起的感染患者方面的知识、态度和准备情况:方法: 采用李克特量表设计了一份问卷,用于评估知识、态度和准备情况。根据干预前的研究结果,在有针对性的教育活动实施前后进行了两次横断面研究:共有 393 名和 420 名医护人员分别参加了干预前和干预后的研究。大多数受访者为女性(77.3%),年龄在 18-34 岁之间(67%)。医护人员的专业角色包括护士(56.3%)、医生(31.6%)和实验室人员(12.2%)。在干预后的研究中,有更多的医护人员表示接受过感染预防与控制(IPC)和抗菌药物耐药性教育和培训(干预前为 26.8%,干预后为 45.5%,P 85% 至 ≥ 95%),并了解 AMR 微生物在医疗机构中的传播方式,知道预防 AMR 感染传播的 IPC 措施,包括手部卫生、标准预防措施和基于传播的预防措施。对 AMR 的态度是积极的,84.2% 的医护人员在干预前和 84.8% 的医护人员在干预后表示愿意改变工作环境,协助预防 AMR。对解决这一问题的意愿则表现不一。实验室 AMR 监测数据的可用性有所改善(29.4%-52.4%,p 结论):我们的数据显示,员工对 AMR 和 IPC 的认识和知识水平较高。然而,应对疫情爆发和治疗严重 AMR 感染的准备工作需要更多关注。改善化武医疗中心的 AMR 预防和控制工作可能需要持续的多部门干预措施和强有力的行政承诺。
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来源期刊
Antimicrobial Resistance and Infection Control
Antimicrobial Resistance and Infection Control PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES
CiteScore
9.70
自引率
3.60%
发文量
140
审稿时长
13 weeks
期刊介绍: Antimicrobial Resistance and Infection Control is a global forum for all those working on the prevention, diagnostic and treatment of health-care associated infections and antimicrobial resistance development in all health-care settings. The journal covers a broad spectrum of preeminent practices and best available data to the top interventional and translational research, and innovative developments in the field of infection control.
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