Amanda J. Hessels

Building Interdisciplinary Research Models Through Interactive Education

Critical interdisciplinary research skills include effective communication with diverse disciplines and cultivating collaborative relationships. Acquiring these skills during graduate education may foster future interdisciplinary research quality and productivity.

Staff Knowledge, Awareness, Perceptions, and Beliefs About Infection Prevention in Pediatric Long-term Care Facilities.

BackgroundThe burden of healthcare-associated infection worldwide is considerable, and there is a need to improve surveillance and infection control practices such as hand hygiene. ObjectivesThe aims of this study were to explore direct care providers’ knowledge about infection prevention and hand hygiene, their attitudes regarding their own and others’ hand hygiene practices, and their ideas and advice for improving infection prevention efforts. MethodsThis exploratory study included interviews with direct care providers in three pediatric long-term care facilities. Two trained nurse interviewers conducted semistructured interviews using an interview guide with open-ended questions. Two other nurse researchers independently transcribed the audio recordings and conducted a thematic analysis using a strategy adapted from the systematic text condensation approach. ResultsFrom 31 interviews, four major thematic categories with subthemes emerged from the analysis: (a) hand hygiene products; (b) knowledge, awareness, perceptions, and beliefs; (c) barriers to infection prevention practices; and (d) suggested improvements. There was confusion regarding hand hygiene recommendations, use of soap or sanitizer, and isolation precaution policies. There was a robust “us” and “them” mentality between professionals. DiscussionOne essential driver of staff behavior change is having expectations that are meaningful to staff, and many staff members stated that they wanted more in-person staff meetings with education and hands-on, practical advice. Workflow patterns and/or the physical environment need to be carefully evaluated to identify systems and methods to minimize cross-contamination. Further studies need to evaluate if personal sized containers of hand sanitizer (e.g., for the pocket, attached to a belt or lanyard) would facilitate improvement of hand hygiene in these facilities.

Relationship between patient safety climate and adherence to standard precautions

BACKGROUND Standard precautions (SPs) are designed to limit bloodborne pathogen exposures among health care workers (HCWs) and health care-associated infections. SP adherence is globally suboptimal; however, reasons are underexplored. This study aim was to explore the relationships among safety climate factors and SP adherence by HCWs in hospitals using newly developed survey and observational tools. METHODS Cross-sectional data from 11 units in 5 hospitals were collected between March and September 2015. A patient safety and standard precaution survey was administered to nurses and pooled with data from observations of HCW-patient interactions using defined SP indications. Descriptive statistics of distributions, frequencies, and Pearson correlation coefficients were calculated to determine the unit-level relationships among dimensions of the patient safety climate and unit percentages of SP adherence (P < .05). RESULTS There were 540 HCW-patient encounters with 1,713 SP indications and 140 surveys collected. Although most nurses (94%) reported always or often adhering to SPs and generally reported positive scores on unit safety climate, observed SP adherence was 62% (unit range, 31%-80%). Only 30% of nurses rated staffing positively, and this was inversely related to observed SP adherence. CONCLUSIONS Adherence to the full complement of observed SP behaviors by HCWs of all types was suboptimal. The relationship between safety climate, particularly staffing, and adherence to SPs warrants further testing.

Reported hours of infection education received positively associated with student nurses' ability to comply with infection prevention practices: Results from a nationwide survey

• Student nurses report that infection prevention practices vary between school and clinical settings.

National Testing of the Nursing-Kids Intensity of Care Survey for Pediatric Long-term Care

Purpose The purpose of this study is to test the Nursing–Kids Intensity of Care, a measure of the intensity of nursing care needs, defined as the quantity and type of direct and indirect care activities performed by caregivers in a national sample. Design and Methods A 40‐item tool previously tested in a small sample was psychometrically tested on a sample of 116 children with complex medical conditions by 33 nurse raters across 11 pediatric sites. Results The Nursing‐Kids Intensity of Care tool demonstrated components of usability, feasibility, inter‐rater, test‐retest and internal consistency reliability and construct validity in the national study sample. Conclusions Additional testing to further establish psychometric sufficiency and expanded use to quantify the intensity of nursing care needs of children with complex medical conditions in pediatric long‐term care settings is recommended. Practice Implications This novel measure could assist the nursing administrators, educators and staff of pediatric long‐term care facilities assess the intensity of care needs of their residents. HighlightsA novel measure, the Nursing–Kids Intensity of Care (N‐KICS) tool, was tested in a national sample.Nursing intensity is defined as the direct and indirect care activities performed by caregivers.N‐KICS demonstrated components of usability, feasibility, reliability and validity in the study sample.N‐KICS can standardize and quantitate the intensity of nursing care needs of pediatric long‐term care residents.

Family Experiences and Perspectives on Infection Prevention in Pediatric Long-Term Care

Purpose Residents of pediatric long-term care facilities (pLTCF) are particularly vulnerable to healthcare-associated infections. The aims of this qualitative study were to (a) explore perspectives on infection prevention among families visiting children in pLTCF and (b) identify facilitators of and barriers to optimal hand hygiene. Design and Methods Semistructured, in-depth interviews with 10 family members visiting two New York City metropolitan area facilities were analyzed to identify themes. Findings “Everyone follows the rules” and “infections are inevitable” were primary themes. Participants reported “common sense” as a facilitator and “distraction” as a major barrier to prevention practices. Conclusion Current education for visitors may be inadequate to improve infection prevention behaviors. Clinical Relevance Nurse-led education strategies for infection prevention should be tested and modified for families visiting pLTCF.

Journal Club: Developing a user-friendly report for electronically assisted surveillance of catheter-associated urinary tract infections

&NA; The article chosen for this Journal Club commentary describes the development and testing of a report format using automated data to report urinary catheter utilization and catheter‐associated urinary tract infections (CAUTIs).1 This research sought to address a gap in knowledge regarding the optimal display and content of data reports, communicating to diverse audiences, which used surveillance data from Department of Veterans Affairs’ electronic health records. The specific research aim of this project was to develop and pilot test report formats deemed usable and trustworthy by the end user, and discover the best way to deliver to the ideal audience automated data, which is formatted and presented in a way that is acceptable to the end user.