Contact precautions for Clostridium dif.cile and Methicillin-resistant Staphylococcus aureus (MRSA)

Abstract

This paper presents an overview of the key findings, key issues and implications emerging from a single case study designed to explore a group of nurses' and healthcare assistants' infection control practice, and to introduce interventions aimed at implementing best practice. The study was undertaken on one hospital ward and the sample comprised all permanently employed nurses and healthcare assistants (n=18). Guidelines on Contract Precautions were developed and informed by an expert panel of infection control nurses (n=100) from across the UK. The detailed investigation of individual participant's responses to the intervention during its implementation provided unique insights into the factors which influence nurses' and healthcare assistants' decisionmaking in relation to infection control practice. Analyses of the data from all three phases of the study revealed that participants experienced great difficulty comprehending infection control recommendations and varied in the extent to which they adopted them. Their capacity to understand and implement these recommendations was hampered, not only by a lack of knowledge, but also by irrational beliefs, inaccurate perceptions of risk, both in relation to themselves and patients, and a lack of ability or willingness to exercise clinical judgement, particularly in relation to glove use. These findings highlight the need for further study in the drive to improve this crucial aspect of health care services.