Highlights
- •Communication of the implications of MDRO was often insufficient and inconsistent.
- •Isolation resulted in positive (privacy) and negative (reduced interaction) effects.
- •Psychological impacts included health concern/anxiety and stigma.
- •Inconsistent management of MDRO by staff and location resulted in frustration.
- •Patient experience is important when developing and implementing MDRO policy.
Abstract
Background
Patients undergoing haemodialysis colonised with multi-drug resistant organisms (MDROs)
are commonly managed with transmission-based precautions (TBP) to prevent nosocomial
transmission. TBP have been linked to mixed effects on patient psychological well-being
and clinical care. This study was designed to report the lived experience of dialysis
patients managed with TBP.
Methods
A qualitative study of 15 patients undergoing haemodialysis managed with TBP was performed.
Participants took part in individual semi-structured interviews. Data was analysed
utilising an interpretive phenomenological approach.
Results
Four themes were identified.
1. Communication of what MDRO screening meant, the results, and implications of MDRO
positivity was perceived by many patients as insufficient and inconsistent.
2. Experiences of care in isolation were described, with both positive (privacy) and
negative (reduced interaction) experiences identified.
3. Psychosocial and emotional responses including concern about health implications
and stigma were reported, but also screening was described by some as increasing their
perception of being cared for by health care workers, as they felt all health risks
were being managed.
4. Confusion around perceived inconsistencies of management, particularly across different
environments (eg hospital vs home) and staff.
Conclusion
TBP have complex positive and negative impacts on patients which should be considered
when developing MDRO management policy and communication around such policy. Strategies
to improve communication, patient and staff education, and remove (or explain) perceived
inconsistencies of practice may reduce the negative consequences of TBP leading to
improved delivery of quality, person-centred care.
Keywords
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Article info
Publication history
Published online: June 08, 2022
Accepted:
May 17,
2022
Received in revised form:
May 11,
2022
Received:
February 15,
2022
Identification
Copyright
© 2022 Australasian College for Infection Prevention and Control. Published by Elsevier B.V. All rights reserved.
