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.


Journal

Antimicrobial resistance and infection control
ISSN: 2047-2994
Titre abrégé: Antimicrob Resist Infect Control
Pays: England
ID NLM: 101585411

Informations de publication

Date de publication:
04 Sep 2024
Historique:
received: 18 04 2024
accepted: 15 07 2024
medline: 4 9 2024
pubmed: 4 9 2024
entrez: 3 9 2024
Statut: epublish

Résumé

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. 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. 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. 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.

Sections du résumé

BACKGROUND 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 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 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 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.

Identifiants

pubmed: 39227975
doi: 10.1186/s13756-024-01439-9
pii: 10.1186/s13756-024-01439-9
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

98

Informations de copyright

© 2024. The Author(s).

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Auteurs

Kirsty Buising (K)

The Royal Melbourne Hospital, 300 Grattan Street, Melbourne, VIC, 3052, Australia.
Department of Infectious Diseases, The University of Melbourne, The Peter Doherty Institute for Infection and Immunity, 792 Elizabeth Street, Melbourne, VIC, 3000, Australia.

Ravi Naidu (R)

Ministry of Health and Medical Services, Colonial War Memorial Hospital, Waimanu road, Suva, Fiji.

Shammi Prasad (S)

Australian Volunteer International, Pacific People Office, Level 2, BSP Central Street, Suva, Fiji.

Matthew Richards (M)

The Royal Melbourne Hospital, 300 Grattan Street, Melbourne, VIC, 3052, Australia.

Savneel Shivam Kumar (SS)

Ministry of Health and Medical Services, Colonial War Memorial Hospital, Waimanu road, Suva, Fiji.

Alvina Lata (A)

Ministry of Health and Medical Services, Colonial War Memorial Hospital, Waimanu road, Suva, Fiji.

Ashlyn Datt (A)

Ministry of Health and Medical Services, Colonial War Memorial Hospital, Waimanu road, Suva, Fiji.

Sisilia Assisi Genaro (SA)

Ministry of Health and Medical Services, Colonial War Memorial Hospital, Waimanu road, Suva, Fiji.

Timaima Ratusela (T)

Ministry of Health and Medical Services, Colonial War Memorial Hospital, Waimanu road, Suva, Fiji.

Ilisapeci Nabose (I)

Ministry of Health and Medical Services, Colonial War Memorial Hospital, Waimanu road, Suva, Fiji.

Donna Cameron (D)

Microbiological Diagnostic Unit Public Health Laboratory, The University of Melbourne, The Peter Doherty Institute for Infection and Immunity, 792 Elizabeth Street, Melbourne, VIC, 3000, Australia.

Ana Suka (A)

Ministry of Health and Medical Services, Colonial War Memorial Hospital, Waimanu road, Suva, Fiji.

Tracey Young-Sharma (T)

Ministry of Health and Medical Services, Colonial War Memorial Hospital, Waimanu road, Suva, Fiji.

Benjamin P Howden (BP)

Microbiological Diagnostic Unit Public Health Laboratory, The University of Melbourne, The Peter Doherty Institute for Infection and Immunity, 792 Elizabeth Street, Melbourne, VIC, 3000, Australia.

Aneley Getahun Strobel (A)

Department of Infectious Diseases, The University of Melbourne, The Peter Doherty Institute for Infection and Immunity, 792 Elizabeth Street, Melbourne, VIC, 3000, Australia. a.getahunstrobel@unimelb.edu.au.

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