Applying terror management theory as a framework to understand the impact of heightened mortality salience on children, adolescents, and their parents: A systematic review.

Terror Management Theory (TMT) posits that controlling death anxiety is a driving force behind many aspects of social behavior. The objective in this systematic review was to explore how TMT is used to explain children's, adolescents', and parents' behavior when exposed to situations that increase mortality salience. A systematic search identified 2484 papers; 14 studies met eligibility criteria. Key topics explored were mortality salience, death thoughts, and distal defenses. Findings indicate that adolescents comprehend death and have mortality salience reactions like adults, highlighting the potential for TMT to be used to explain children's and adolescents' social behavior in high-stress situations.

Environmental cleaning and infection prevention and control: The role of Patient Service Assistants.

BACKGROUND: In Australia, Patient Service Assistants are an integral part of all health care settings, yet there is a paucity of studies considering their understandings and perceptions of their role about infection prevention and control. The aim in this study was to explore haematology Personal Service Assistants' experience, understanding and perceptions of their role in improving patient safety through environmental cleaning. METHODS: A qualitative exploratory descriptive design was utilised to collect data from cleaning staff via focus groups. Three semi-structured focus groups were conducted. RESULTS: Seven Patient Service Assistants participated in the study out of 11 employed. Two key themes emerged from the thematic analysis: (1) Playing a major role in Infection Prevention and Control, and (2) prioritising good interpersonal relationships over promoting infection prevention and control. Patient Service Assistants emphasised the importance of their involvement in keeping the ward clean, including patients' rooms and surroundings, to prevent cross infection. Most participants underlined the dilemmas they faced when visitors and/or informal cleaning employees or casual ward staff did not adhere to ward infection prevention and control norms. CONCLUSION: Patient Service Assistants were employing key infection prevention and control principles in their ward cleaning routine, with the aim of achieving a safer patient environment although they were reluctant to challenge observed practice deviations. The role of Patient Service Assistants highlights the widely held misconception that patient safety is solely dependent on healthcare workers.

An investigation into nursing students' application of infection prevention and control precautions.

BACKGROUND: Undergraduate education of Health Care Workers is pivotal to ensuring that frontline clinicians have appropriate knowledge and skills in Infection Prevention and Control (IPC). OBJECTIVES: The aim of this study was to describe undergraduate nursing students' self-reported compliance with Standard Precautions and to explore the psychosocial factors that influence adherence in clinical practice. DESIGN: A cross-sectional survey design was used. SETTING: The study was conducted in the School of Nursing and Midwifery at an Australian University. PARTICIPANTS: All undergraduate nursing students were invited to participate in an online survey; 321 participated, mean age 25.7 years (SD = 8.4). The majority, 196 (61%), had no healthcare work experience, 54 (17%) were patient-care assistants, 40 (13%) enrolled nurses, and 31 (9%) were nurses registered overseas. METHODS: Two validated instruments were used: the Compliance with Standard Precautions Scale (CSPS) and the Factors Influencing Adherence to Standard Precautions Scale- Student version (FIASPS-SV). Linear regression was used to measure the impact of psychosocial factors on self-reported compliance. RESULTS: Overall self-reported compliance with prevention of cross-infection was 83%, use of Personal Protective Equipment (81%), correct disposal of sharps (83%) and general waste (75%), and equipment decontamination (69%). The predominant factors endorsed on the FIASPS-SV were 'Leadership' (M = 15.21 SD = 5.28) and 'Contextual cues' (M = 19.09 SD = 6.37). Multivariate linear regression demonstrated that after adjusting for age, gender and years of nursing study, the Leadership factor predicted participants' self-reported compliance on the 'prevention of cross-infection' (p < .001), 'use of PPE' (p < .001), 'waste disposal' (p = .021), and 'decontamination of equipment' (p < .001) sub-domains of the CSPS. CONCLUSIONS: These findings highlight that strong clinical leadership and role modelling are essential to ensure all healthcare students prioritise rigorous adherence with infection prevention and control guidelines.

Nursing students' awareness and perceptions of nurses' role in antimicrobial stewardship.

Antimicrobial resistance is a major threat to public health worldwide. Antimicrobial stewardship programs and interventions aiming to optimise the use of antibiotics, are increasingly used to ensure judicious use of antibiotics and limit the emergence of antimicrobial resistance. Nurses are pivotal in antimicrobial stewardship however nursing students' awareness of such programs has not been investigated. This study aimed to elicit nursing students' perspectives and perceptions of the nurse's role in antimicrobial stewardship. A cross-sectional design was utilised to survey pre-registration nursing students. A total of 321 nursing students enrolled in an Australian university participated. The survey comprised questions on knowledge and opinions regarding the nurse's role in AMS and on a range of topics relating to antimicrobial stewardship and antimicrobial resistance, through closed and open-ended questions. While 44.5% of participants indicated they were familiar with the term Antimicrobial Stewardship, 70.7% believed they had very little or no knowledge of the principles. Completion of subjects with a focus on quality and safety in nursing practice and quality use of medications was associated with greater awareness. Findings underscore the need to engage nursing students in discussions exploring the problem of antimicrobial resistance and the important role nurses play in Antimicrobial Stewardship programs.

Paediatric nurses', children's and parents' adherence to infection prevention and control and knowledge of antimicrobial stewardship: A systematic review.

INTRODUCTION: Infection prevention and control precautions help to decrease microbial transmission, and through the appropriate use of antibiotics, Antimicrobial Stewardship programs aim to decrease the prevalence and emergence of Antimicrobial Resistance. METHODS: A systematic review was undertaken to critically appraise and synthesise evidence for nurses', children's and parents' knowledge and understanding of antimicrobial stewardship, and of infection prevention and control in acute paediatric care settings. The Preferred Reporting Items for Systematic reviews and Meta-Analyses guided the review. Studies were included if they examined the factors that contributed to nurses' adherence to, or consumers' practice in relation to, antimicrobial stewardship and infection prevention and control. RESULTS: Of the 16,957 papers identified, 50 studies conducted in acute paediatric settings met the eligibility criteria, and were included. Most studies were of low methodological quality. Fourteen studies evaluated nurses' knowledge and self-reported adherence to Infection Prevention and Control principles and identified consistent practice gaps by nurses. Six studies evaluating the effectiveness of education programs reported modest improvements in nurses' knowledge and adherence to infection prevention and control. There were 15 studies, that investigated consumers' involvement in infection prevention and control that identified the following themes: Consumer knowledge and attitudes to infection prevention and control and transmission-based precautions, and parents' willingness to take an active role in infection prevention. Six studies focused on paediatric nurses' role in antimicrobial stewardship, exploring the following themes: (1) nurses' understanding and beliefs of antimicrobial stewardship roles, and (2) barriers to nurses taking a greater role in antimicrobial stewardship. Nine studies explored the role of consumers in antimicrobial stewardship and identified consumers' misconceptions about the benefits and downplayed concerns regarding antibiotic use. DISCUSSION: Although consumers articulated a willingness to be actively involved in infection prevention, observed practice remained lower than that required to consistently prevent infection transmission. CONCLUSION: These findings highlight a critically important gap in current practice. In relation to optimal use of antimicrobials, although paediatric nurses were involved in supporting antimicrobial stewardship processes and educating consumers, they identified limited antimicrobial stewardship knowledge. Consumers appeared to lack understanding about the benefits of antibiotics and negated concerns regarding antibiotic use.

The Factors Influencing Adherence to Standard Precautions Scale - Student version (FIASP- SV): A psychometric validation.

BACKGROUND: Standard Precautions have been demonstrated to limit infection transmission in the healthcare setting. Despite their mandated use, adherence by healthcare professionals remains suboptimal. A nursing curriculum embedding infection prevention and control is essential in equipping future healthcare professionals with the skills and knowledge to improve patient safety. There are no psychometrically-validated tools that specifically assess influences on nursing students' adherence to standard precautions. METHODS: The aim in this study was to determine the reliability and validity of the five-factor Factors Influencing Adherence to Standard Precautions within a sample of undergraduate nursing students studying at one Australian University. RESULTS: Data from 321 participants were used to test the 5 factors structure, using Confirmatory Factor Analysis. The goodness of fit indices did not support adequate fit of the data and the data were submitted to a random split-half sample factor analysis process. A four-factor solution was extracted with good to acceptable internal reliabilities (α = .66 -.80). CONCLUSION: There are distinctive differences in the factors that influence student versus registered nurses' behaviour and clinical decision-making in relation to use of SP. The Factors Influencing Adherence to Standard Precautions (Student Version) has good psychometric properties and is suitable for use with nursing students. Having measures specific to students is essential as measures developed for healthcare professionals might not be applicable to a nursing student population.

Nurse's perceptions on infection prevention and control in atopic dermatitis in children.

BACKGROUND: Nurses should be conscious of healthcare associated infections, and the standard precautions required to reduce the risk of patients becoming infected. Patients with atopic dermatitis are often predisposed to a higher incidence of bacterial and viral infections. This study aims to explore and describe nurses' understanding and knowledge of their role in infection control and prevention precautions when caring for children with atopic dermatitis. METHODS: Sixteen nurses were recruited from the dermatology clinic, medical wards and emergency department of a metropolitan tertiary referral children hospital for a qualitative exploratory descriptive study. RESULTS: Thematic and content analysis derived three themes from the data: "the importance of infection prevention and control when managing children with atopic dermatitis", "nurses focus on self-protection", and "educating families on infection prevention and control". CONCLUSION: Nurses' perceptions of their role emphasised the need to limit cross-infection between patients when children were admitted with exacerbations of atopic dermatitis. Participants articulated that in their own practice personal protective equipment (PPE) was often used for self-protection and to protect their uniform rather than to protect the child from cross-infection. The importance of providing family members with sufficient education to assist them in managing the child at home was also particularly salient. The importance nurses placed on educating patients and family members about home-management, preventing cross-infection and minimising the occurrence of future exacerbations of atopic dermatitis, highlights the potential to develop interventions to support greater consumer participation in infection prevention for children with chronic relapsing conditions such as atopic dermatitis.

Antimicrobial stewardship and infection prevention and control in atopic dermatitis in children.

Atopic dermatitis is a chronic, recurrent inflammatory skin disease, characterized by frequent exacerbations that can necessitate increased antibiotic use. A qualitative study was conducted at a specialist pediatric hospital to explore the perceptions of dermatology nurses on their role in antimicrobial stewardship when caring for children with atopic dermatitis. Thematic and content analysis derived that the awareness of nurses on antimicrobial stewardship was low, although they were implementing key elements in their clinical practice.