The Factors Influencing Compliance of Multidrug-resistant Organism Infection Control in Intensive Care Units Nurses

Ji Hee Kim; Kyung Hee Lim

doi:10.7469/kjan.2015.27.3.325

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Kim and Lim: The Factors Influencing Compliance of Multidrug-resistant Organism Infection Control in Intensive Care Units Nurses

Original Article

Korean J Adult Nurs 2015;27(3):325-336.

Published online: NaN June 2015

DOI: https://doi.org/10.7469/kjan.2015.27.3.325

The Factors Influencing Compliance of Multidrug-resistant Organism Infection Control in Intensive Care Units Nurses

Ji Hee Kim¹, Kyung Hee Lim²

^¹Keimyung University Dongsan Medical Center · Keimyung University Research Institute of Nursing Science, Daegu

^²College of Nursing, Keimyung University · Keimyung University Research Institute of Nursing Science, Daegu, Korea

Corresponding author: Lim, Kyung Hee College of Nursing, Keimyung University, 1095 Dalgubeol-daero, Daegu 704-701, Korea. Tel: +82-53-580-3909, Fax: +82-53-580-3904, E-mail: khlim7@kmu.ac.kr

Received 1 April 201511 June 2015 Accepted 11 June 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was conducted to identify factors influencing compliance of multidrug-resistant organism infection control in intensive care units (ICU) nurses.

Methods

Data were collected from 254 ICU nurses who were working at 6 general and advanced general hospitals in D city and G Province.

Results

77.2% and 84.4% of the subjects correctly answered to questions about Methicillin-Resistant Staphylococcus Aureus (MRSA) and Vancomycin Resistant Enterococcus (VRE), respectively. The scores of MRSA infection control compliance and VRE infection control compliance were 3.41 and 3.43, respectively. The factors influencing MRSA infection control compliance were empowerment, environmental safety recognition, and education satisfaction, which explained 30% of MRSA infection control compliance. The factors significantly related to VRE infection control compliance were empowerment, hospital types, environmental safety recognition, number of education sessions, and neonatal ICU, which explained 37% of VRE infection control compliance.

Conclusion

It is necessary to develop efficient educational programs for infection control including educational contents to improve empowerment and environmental safety recognition of nurses. Furthermore, administrative support for those infection control programs is also necessary.

Keywords: Infection control, Intensive care units, Methicillin-resistant staphylococcus aureus, Vancomycin resistance, Enterococcus

REFERENCES

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Table 1.

The Mean Scores of the Study Variables for Multidrug-resistant Organism Infection (N=254)

Scale		M±SD
Knowledge on MRSA		12.35±1.41
Knowledge on VRE		13.50±1.27
Environmental safety recognition		3.02±0.41
Empowerment	Meaning	3.97±0.82
	Competence	3.31±0.83
	Self-determination	3.37±0.86
	Impact	3.34±0.81
	Total	3.50±0.70
Compliance with MRSA infection control	Hand washing	3.56±0.47
	Isolation	3.17±0.73
	Gloving	3.66±0.51
	Wearing mask	3.43±0.76
	Environment management	3.30±0.61
	Total	3.41±0.61
Compliance with VRE infection control	Isolation	3.34±0.50
	Hand washing	3.67±0.42
	Environment management	3.43±0.58
	Total	3.43±0.44

MRSA=methicillin-resistant staphylococcus aureus; VRE=vancomycin-resistant enterococcus.

Table 2.

Score Differences of the Main Variables according to the General Characteristics (N=254)

Characteristics	Categories	n (%)	Knowledge on MRSA		Knowledge on VRE		Environmental safety recognition		Empowerment		Compliance with MRSA Infe5ction Control		Compliance with VRE Infection Control
Characteristics	Categories	n (%)	M±SD t	t or F (p)	M±SD t	or F (p)	M±SD	t or F (p)	M±SD	t or F (p)	M±SD	t or F (p)	M±SD	t or F (p)
Age (year)	＜25^a	64 (25.2)	12.17±1.41	0.91	13.45±1.25	1.68	2.97±0.39	4.50	3.24±0.69	11.23	3.30±0.50	14.25	3.38±0.43	2.95
	25~29^b	85 (33.5)	12.28±1.47	(.435)	13.35±1.38	(.171)	2.99±0.38		3.40±0.57	(＜.001)	3.37±0.45		3.36±0.45	(.033)
	30~34^c	51 (20.0)	12.47±1.41		13.45±1.12		2.95±0.48	(.004)	3.54±0.78	a, b, c＜d	3.40±0.47	(＜.001)	3.50±0.47
	≥35^d	54 (21.3)	12.56±1.31		13.83±1.24		3.20±0.39	a, b, c＜d	3.91±0.64		3.63±0.35	a, b＜d	3.36±0.37
Education	3-year course^a	117 (46.1)	12.21±1.40	1.36	13.42±1.33	0.44	3.01±0.41	0.08	3.40±0.77	3.90	3.42±0.49	0.00	3.45±0.47	0.00
	4-year course^b	108 (42.5)	12.44±1.33	(.260)	13.56±1.25	(.643)	3.03±0.43	(.930)	3.53±0.64	(.022)	3.38±0.45	(.931)	3.40±0.45	(.984)
	≥Master degree^c	29 (11.4)	12.62±1.68		13.59±1.27		3.04±0.39		3.80±0.50	a＜c	3.48±0.35		3.49±0.29
Marital status	Single	168 (66.1)	12.20±1.40	-2.36	13.38±1.26	-2.21	2.99 (0.40)	-1.73	3.39±0.66	-3.63	3.39±0.47	-1.07	3.43±0.43	-0.25
Marital status	Married	86 (33.9)	12.64±1.40	(.019)	13.74±1.27	(.028)	3.09 (0.45)	(.085)	3.71±0.73	(＜.001)	3.46±0.43	(.284)	3.44±0.47	(.802)
Clinical experience (year)	＜3	86 (33.9)	12.05±1.50	-2.49	13.52±1.22	0.21	2.97±0.38	-1.53	3.24±0.65	-4.41	3.31±0.48	-2.62	3.37±0.43	-1.72
Clinical experience (year)	≥3	168 (66.1)	12.51±1.33	(.014)	13.49±1.30	(.835)	3.05±0.43	(.127)	3.63±0.69	(＜.001)	3.47±0.44	(.009)	3.47±0.44	(.087)
ICU experience (year)	＜3	124 (48.8)	12.10±1.47	-2.75	13.43±1.30	-0.89	2.96±0.39	-2.28	3.32±0.67	-4.13	3.33±0.48	-2.75	3.37±0.44	-2.17
ICU experience (year)	≥3	130 (51.2)	12.58±1.32	(.006)	13.57±1.25	(.376)	3.08±0.43	(.023)	3.67±0.69	(＜.001)	3.48±0.44	(.006)	3.50±0.43	(.031)
ICU unit	MICU^a	88 (34.6)	12.32±1.48	1.43	13.33±1.31	1.43	3.05±0.40	0.39	3.57±0.71	0.75	3.43±0.45	1.19	3.53±0.39	4.46
	SICU^b	80 (31.5)	12.41±1.29	(.224)	13.64±1.25	(.224)	3.02±0.45	(.816)	3.51±0.68	(.558)	3.43±0.43	(.318)	3.49±0.47	(.002)
	NSICU^c	52 (20.5)	12.58±1.53		13.38±1.30		2.99±0.42		3.42±0.77		3.44±0.44		3.34±0.44	a＞d
	Neonatal ICU^d	25 (9.9)	12.16±1.25		13.92±1.15		2.97±0.62		3.46±0.56		3.30±0.55		3.22±0.35
	General ICU^e	9 (3.5)	11.33±1.12		13.44±1.13		3.11±0.53		3.24±0.81		3.17±0.55		3.17±0.53
Hospital	General Advanced general	108 (42.5)	12.17±1.42	-1.80	13.60±1.24	1.10	3.05±0.46	0.98	3.45±0.81	-0.98	3.44±0.46	1.03	3.57±0.41	4.34
Hospital	General Advanced general	146 (57.5)	12.49±1.40	(.074)	13.42±1.30	(.273)	3.00±0.38	(.331)	3.53±0.60	(.331)	3.39±0.46	(.303)	3.33±0.44	(＜.001)
Position	Staff	233 (91.7)	12.34±1.39	-0.27	13.44±1.27	-2.44	3.00±0.41	-2.75	3.46±0.68	-3.07	3.34±0.47	-3.71	3.41±0.44	-3.69
Position	Charge	21 (8.3)	12.43±1.69	(.791)	14.14±1.20	(.015)	3.26±0.40	(.006)	3.94±0.83	(.002)	3.63±0.27	(.001)	3.68±0.30	(.001)
Job satisfaction	Disagree	30 (11.8)	12.10±1.21	0.54	13.57±1.41	0.10	2.84±0.38	3.23	3.51±0.80	0.10	3.37±0.49	0.58	3.49±0.48	0.31
	Neutral	128 (50.4)	12.39±1.40	(.584)	13.47±1.16	(.912)	3.05±0.41	(.041)	3.48±0.68	(.902)	3.39±0.44	(.563)	3.42±0.46	(.733)
	Agree	96 (37.8)	12.38±1.48		13.52±1.38		3.05±0.43		3.52±0.70		3.45±0.47		3.44±0.40
Education	No	45 (17.7)	12.31±1.40	0.94	13.31±1.56	0.94	2.89±0.35	2.46	3.27±0.64	2.45	3.37±0.50	0.67	3.36±0.41	1.31
experience of MRSA & VRE	Yes	209 (82.3)	12.36±1.41	(.837)	13.54±1.21	(.354)	3.05±0.42	(.015)	3.55±0.71	(.015)	3.42±0.45	(.506)	3.45±0.44	(.191)
	Educational method
	Lecture	168 (80.4)	12.31±1.42	1.50	13.51±1.22	0.86	3.05±0.42	2.13	3.51±0.69	2.25	3.41±0.49	1.30	3.43±0.44	1.98
	Others	12 (5.8)	12.08±1.62	(.227)	13.33±1.07	(.424)	2.85±0.28	(.122)	3.45±0.63	(.108)	3.25±0.50	(.276)	3.36±0.54	(.141)
	≥2 methods	29 (13.8)	12.76±1.24		13.79±1.18		3.14±0.48		3.80±0.80		3.39±0.41		3.60±0.41
	Educational satisfaction
	Yes	139 (66.5)	12.47±1.33	1.57	13.63±1.15	1.45	3.11±0.42	2.90	3.56±0.69	0.46	3.48±0.45	2.55	3.50±0.42	2.14
	No	70 (33.5)	12.14±1.57	(.117)	13.37±1.30	(.150)	2.93±0.41	(.004)	3.52±0.73	(.643)	3.31±0.44	(.012)	3.36±0.49	(.034)

MRSA=methicillin-resistant staphylococcus aureus; VRE=vancomycin-resistant enterococcus.

Table 3.

Correlations of the Main Variables for Multidrug-resistant Organism Infection Control (N=254)

Variables	No. of education sessions	Knowledge	Environmental safety recognition	Empowerment
Variables	r (p)	r (p)	r (p)	r (p)
Compliance with MRSA infection control	.25 (＜.001)	.00 (.956)	.39 (＜.001)	.49 (＜.001)
Compliance with VRE infection control	.30 (＜.001)	.10 (.126)	.40 (＜.001)	.44 (＜.001)

MRSA=methicillin-resistant staphylococcus aureus; VRE=vancomycin-resistant enterococcus.

Table 4.

Factors Affecting Compliance with MRSA & VRE Infection Control (N=254)

Dependent variables	Independent variables	B	SE	β	t	p
Compliance with MRSA infection control	Empowerment	.23	.00	.42	6.70	＜.001
	Environmental safety recognition	.30	.01	.20	2.85	.003
	Educational satisfaction	.12	.06	.12	2.03	.044
			Adj. R²=.30, F=30.82, p＜.001
Compliance with VRE infection control	Empowerment	.02	.00	.39	6.49	＜.001
	Secondary hospital	.23	.05	.25	4.46	＜.001
	Environmental safety recognition	.03	.01	.21	3.40	.001
	No. of education sessions	.26	.08	.19	3.22	.002
	Neonatal ICU	-.08	.03	-.14	-2.42	.016
			Adj. R²=.37, F=25.36, p＜.001

Adj. R²=Adjusted R²; MRSA=me ethicillin-resistant staphylococcus aureus; VRE =vancomycin-res sistant enteroc coccus.

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