Influences of healthcare workers' behaviours towards infection prevention and control practices in the clinical setting: A systematic review.

AIM: To systematically evaluate empirical studies investigating the influences of healthcare workers' behaviours towards infection prevention and control practices in the Coronavirus clinical space, and to appraise and synthesise these findings. DESIGN: A systematic review of the literature. METHODS: The review used a five-step framework described by Khan et al. (Journal of the Royal Society of Medicine, 2003, 96 and 118) of Framing questions for a review; Identifying relevant work; Assessing the quality of studies; Summarising the evidence; and Interpreting the findings. Searches were conducted in CINHAL, MEDLINE, PsychINFO, Scopus, and Google Scholar databases to retrieve relevant peer-reviewed literature published in English between 2019 and 2023. Covidence and Joanna Briggs Quality appraisal tools were used for critical assessment. To improve transparent reporting, this review used a Synthesis Without Meta-analysis (SWiM) in systematic review guidelines, as informed by Campbell et al. (BMJ, 2020, 368). RESULTS: Twenty studies were included in this review, identifying nine themes describing factors influencing HCWs' behaviours towards IPC practices in the coronavirus environment. The overarching influences emerged as knowledge-oriented, person-oriented, and environment-oriented. CONCLUSION: Healthcare workers' responsibilities at point-of-care involve providing direct care to patients with highly transmissible infections and working in clinical settings that may be ill-designed for IPC practices, increasing the risk of transmission. Given the lack of a definitive solution to eradicate new mutant viruses and that IPC practices are the mainstay of prevention and control of transmissible, measures to improve are imperative. The identified HCWs' domains on behaviours towards IPC are critical in strategies to mitigate risks and further set an opportunity for developing an IPC model congruent with the rapid response required for HCWs during emerging or re-merging mutant virus outbreaks. This is significant, given that HCWs' preparedness with IPC practices at point-of-care is central to patient care, the workforce and community safety.

A phenomenological exploration of source isolation in patients infected with multi-drug resistant organisms.

BACKGROUND: The physical isolation of patients colonised or infected with multi-drug resistant organisms is a requirement in hospitals considering the risk of infecting other patients, healthcare workers and visitors. However, how these patients experience isolation in the current environment is not fully understood from the literature. AIMS: To explore and interpret the lived experience of the source isolation in patients infected with MDROs within an Australian setting. DESIGN: Hermeneutic phenomenology was utilised as the philosophical framework. METHODS: Unstructured in-depth face to face interviews were conducted with 20 patients infected with multi-drug resistant organisms who were physically isolated. Data was collected from February-2018 to January-2019 at two large teaching hospitals in the Sydney metropolitan area. The interviews were recorded, transcribed verbatim, analysed using thematic analysis by three researchers, and then subsequently interpreted, drawing insights from the relevant phenomenological notions. RESULTS: Three key findings emerged from the study as: Living in a changed space - developed from the participants' struggle to cope with being physically confined to a room that made them feel imprisoned. Living in a changed body - emerged from the participants who described their bodies as 'different' because of bacteria that conventional medicine could not destroy permanently but kept relapsing. Striving to survive - developed from participants who spoke about means of enduring some unfavourable experiences. CONCLUSION: The essence of the lived experience of the phenomenon of source isolation from the perspectives of patients who become infected with MDROs emerged as Being-in-a-changed-world. IMPACT: While source isolation is an important procedure for preventing and controlling transmissible infection; it often results in adverse psychological experiences. An understanding of this finding from the patients' perspectives is essential for nurses and other healthcare workers involved in their care to maintain a balance between infection control isolation and psychological needs.

Registered nurses' perspectives on how patients with multi-drug resistant organisms experience isolation.

BACKGROUND: The isolation of people with transmissible diseases have been known from ancient times. While this topic has been explored from the patients' lived experiences; there is a lack of studies conducted from other viewpoints particularly that of the nurses who provide care to these patients in a 24-hour-period each day. This study explored the experience of source isolation in patients infected with multi-drug resistant organisms, from the nurses' perspectives. METHODS: The Heideggerian (Heidegger, 1962) philosophical ideas formed the overarching framework in which this study was undertaken. Sixteen Registered Nurses were recruited from two New South Wales major hospitals with whom in-depth face-to-face interviews were conducted. Using Braun and Clarke's (2006) tool for the analysis of their data; van Manen's (1990) lifeworld existentials mainly provided a guide for the reflection. RESULTS: Four main themes which emerged from the analysis and interpretation of data are Changed relationships; A controlled space; Fear of infection; and Demanding single rooms - craving for privacy. CONCLUSION: The key understandings drawn from the results were that most of the participants described the patients' experiences of their source isolation as unfavourable. This had resulted in these patients feeling excessively controlled and not given enough opportunities to interact with other people within or outside their space; except for a few who wanted privacy. They also reported how other patients held great fear that their infection might have dire consequences on themselves or other people if they became infected.