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Perspectives of hospital leaders and staff on patient education for the prevention of healthcare-associated infections

Published online by Cambridge University Press:  07 July 2021

Sarah R. MacEwan Open the ORCID record for Sarah R. MacEwan [Opens in a new window] ,
Eliza W. Beal ,
Alice A. Gaughan ,
Cynthia Sieck  and
Ann Scheck McAlearney
Sarah R. MacEwan*
Affiliation:
The Center for Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio
Eliza W. Beal
Affiliation:
The Center for Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio Department of Surgery, College of Medicine, The Ohio State University, Columbus, Ohio
Alice A. Gaughan
Affiliation:
The Center for Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio
Cynthia Sieck
Affiliation:
The Center for Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, Ohio
Ann Scheck McAlearney
Affiliation:
The Center for Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, Ohio
*
Author for correspondence: Sarah R. MacEwan, E-mail: Sarah.MacEwan@osumc.edu
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Abstract

Objective:

Device-related healthcare-associated infections (HAIs), such as catheter-associated urinary tract infections (CAUTIs) and central-line–associated bloodstream infections (CLABSIs), are largely preventable. However, there is little evidence of standardized approaches to educate patients about how they can help prevent these infections. We examined the perspectives of hospital leaders and staff about patient education for CAUTI and CLABSI prevention to understand the challenges to patient education and the opportunities for improvement.

Methods:

In total, 471 interviews were conducted with key informants across 18 hospitals. Interviews were analyzed deductively and inductively to identify themes around the topic of patient education for infection prevention.

Results:

Participants identified patient education topics specific to CAUTI and CLABSI prevention, including the risks of indwelling urinary catheters and central lines, the necessity of hand hygiene, the importance of maintenance care, and the support to speak up. Challenges, such as lack of standardized education, and opportunities, such as involvement of patient and family advisory groups, were also identified regarding patient education for CAUTI and CLABSI prevention.

Conclusions:

Hospital leaders and staff identified patient education topics, and ways to deliver this information, that were important in the prevention of CAUTIs and CLABSIs. By identifying both challenges and opportunities related to patient education, our results provide guidance on how patient education for infection prevention can be further improved. Future work should evaluate the implementation of standardized approaches to patient education to better understand the potential impact of these strategies on the reduction of HAIs.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 43 , Issue 9 , September 2022 , pp. 1129 - 1134
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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References

Estimating the additional hospital inpatient cost and mortality associated with selected hospital-acquired conditions. Agency for Healthcare Research and Quality website. https://www.ahrq.gov/hai/pfp/haccost2017-results.html. Published 2017. Accessed March 5, 2021.Google Scholar
Klevens, RM, Edwards, JR, Richards, CL Jr, et al. Estimating health care-associated infections and deaths in US hospitals, 2002. Public Health Rep 2007;122:160–166.CrossRefGoogle Scholar
Gould, C, Umscheid, C, Agarwal, R, Kuntz, G, Pegues, D, Healthcare Infection Control Practices Advisory Committee. Guideline for prevention of catheter-associated urinary tract infections 2009. Centers for Disease Control and Prevention website. https://www.cdc.gov/infectioncontrol/pdf/guidelines/cauti-guidelines-H.pdf. Published 2019. Accessed March 5, 2021.Google Scholar
Checklist for prevention of central-line–associated bloodstream infections. Centers for Disease Control and Prevention website. https://www.cdc.gov/hai/pdfs/bsi/checklist-for-CLABSI.pdf. Accessed March 5, 2021.Google Scholar
Berger, Z, Flickinger, TE, Pfoh, E, Martinez, KA, Dy, SM. Promoting engagement by patients and families to reduce adverse events in acute-care settings: a systematic review. BMJ Qual Saf 2014;23:548–555.CrossRefGoogle ScholarPubMed
Longtin, Y, Sax, H, Leape, LL, Sheridan, SE, Donaldson, L, Pittet, D. Patient participation: current knowledge and applicability to patient safety. Mayo Clin Proc 2010;85:53–62.CrossRefGoogle ScholarPubMed
Fernandes Agreli, H, Murphy, M, Creedon, S, et al. Patient involvement in the implementation of infection prevention and control guidelines and associated interventions: a scoping review. BMJ Open 2019;9:e025824.CrossRefGoogle ScholarPubMed
McGuckin, M, Govednik, J. Patient empowerment and hand hygiene, 1997–2012. J Hosp Infect 2013;84:191–199.CrossRefGoogle ScholarPubMed
Patient resources. The Society for Healthcare Epidemiology of America. https://www.shea-online.org/index.php/practice-resources/patients. Published 2021. Accessed March 5, 2021.Google Scholar
FAQs about catheter-associated bloodstream infections. The Society for Healthcare Epidemiology of America. https://www.shea-online.org/images/patients/NNL_CA-BSI.pdf. Accessed May 25, 2021.Google Scholar
FAQs about catheter-associated urinary tract infection. The Society for Healthcare Epidemiology of America. https://www.shea-online.org/images/patients/NNL_CA-UTI.pdf. Accessed May 25, 2021.Google Scholar
Central-line–associated bloodstream infections: resources for patients and healthcare providers. Centers for Disease Control and Prevention website. https://www.cdc.gov/hai/bsi/clabsi-resources.html. Published 2011. Accessed May 25, 2021.Google Scholar
Catheter-associated urinary tract infections (CAUTIs). Centers for Disease Control and Prevention website. https://www.cdc.gov/hai/ca_uti/uti.html. Published 2015. Accessed May 25, 2021.Google Scholar
Safdar, N, Codispoti, N, Purvis, S, Knobloch, MJ. Patient perspectives on indwelling urinary catheter use in the hospital. Am J Infect Control 2016;44:e23–e24.CrossRefGoogle ScholarPubMed
Anderson, M, Ottum, A, Zerbel, S, Sethi, A, Safdar, N. Are hospitalized patients aware of the risks and consequences of central-line–associated bloodstream infections? Am J Infect Control 2013;41:1275–1277.CrossRefGoogle ScholarPubMed
McAlearney, AS, Hefner, JL, Sieck, CJ, et al. Searching for management approaches to reduce HAI transmission (SMART): a study protocol. Implement Sci 2017;12:82.CrossRefGoogle ScholarPubMed
Armat, M, Assarroudi, A, Rad, M, Sharifi, H, Heydari, A. Inductive and deductive: ambiguous labels in qualitative content analysis. Qual Rep 2018;23:219–221.Google Scholar
Vaismoradi, M, Turunen, H, Bondas, T. Content analysis and thematic analysis: implications for conducting a qualitative descriptive study. Nurs Health Sci 2013;15:398–405.CrossRefGoogle ScholarPubMed
Miles, MB, Huberman, AM. Qualitative Data Analysis: An Expanded Sourcebook. Thousand Oaks, CA: Sage Publications; 1994.Google Scholar
Crabtree, BF, Miller, WL. Using codes and code manuals: a template organizing style of interpretation. In: Crabtree BF, Miller WL, eds. Doing Qualitative Research. Thousand Oaks, CA: Sage Publications; 1999:163–177.Google Scholar
Glaser, BG, Strauss, AL. The Discovery of Grounded Theory: Strategies for Qualitative Research. Hawthorne, NY: Aldine de Gruyter; 1967.Google Scholar
Constas, MA. Qualitative analysis as a public event: the documentation of category development procedures. Am Educ Res J 1992;29:253–266.CrossRefGoogle Scholar
Bell, SK, Martinez, W. Every patient should be enabled to stop the line. BMJ Qual Saf 2019;28:172–176.CrossRefGoogle Scholar
Görig, T, Dittmann, K, Kramer, A, Heidecke, C-D, Diedrich, S, Hübner, NO. Active involvement of patients and relatives improves subjective adherence to hygienic measures, especially selfreported hand hygiene: results of the AHOI pilot study. Antimicrob Resist Infect Control 2019;8:201.CrossRefGoogle ScholarPubMed
Fisher, KA, Smith, KM, Gallagher, TH, Huang, JC, Borton, JC, Mazor, KM. We want to know: patient comfort speaking up about breakdowns in care and patient experience. BMJ Qual Saf 2019;28:190–197.CrossRefGoogle ScholarPubMed
Volk, R, Obeid, N. What can we do about Dr. Google? Using the electronic medical record (EMR) to prescribe reliable online patient education. J Med Libr Assoc 2019;107:606–608.CrossRefGoogle ScholarPubMed
Cook, L, Castrogiovanni, A, David, D, et al. Patient education documentation: is it being done? Medsurg Nurs 2008;17:306–310.Google Scholar
Shipman, JP, Lake, EW, Van Der Volgen, J, Doman, D. Provider documentation of patient education: a lean investigation. J Med Libr Assoc 2016;104:154–158.CrossRefGoogle ScholarPubMed
Park, J, Seale, H. Examining the online approaches used by hospitals in Sydney, Australia to inform patients about healthcare associated infections and infection prevention strategies. BMC Infect Dis 2017;17:788–788.CrossRefGoogle ScholarPubMed
Zellmer, C, Zimdars, P, Safdar, N. Usefulness of patient education materials for central-line–associated blood stream infection prevention. Int J Infect Control 2016;12:1–5.Google Scholar
McHugh, S, Corrigan, M, Dimitrov, B, et al. Role of patient awareness in prevention of peripheral vascular catheter-related bloodstream infection. Infect Control Hosp Epidemiol 2011;32:95–96.CrossRefGoogle ScholarPubMed
Vanhoozer, G, Lovern Bs, I, Masroor, N, et al. Chlorhexidine gluconate bathing: patient perceptions, practices, and barriers at a tertiary care center. Am J Infect Control 2019;47:349–350.CrossRefGoogle ScholarPubMed
DeLa Cruz, R, Caillouet, B, Guerrero, S. Strategic patient education program to prevent catheter-related bloodstream infection. Clin J Oncol Nurs 2012;16:E12–E17.CrossRefGoogle ScholarPubMed
Møller, T, Borregaard, N, Tvede, M, Adamsen, L. Patient education—a strategy for prevention of infections caused by permanent central venous catheters in patients with haematological malignancies: a randomized clinical trial. J Hosp Infect 2005;61:330–341.CrossRefGoogle ScholarPubMed
Spencer, TS, Flynn Makic, MB, Shaw, K. Decreasing catheter-associated urinary tract infections in urologic oncology patients discharged with an indwelling urinary catheter: a quality improvement project. J Perianesth Nurs 2019;34:394–402.CrossRefGoogle ScholarPubMed
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