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Barriers to adherence to cystic fibrosis infection control guidelines
Elizabeth Garber1, Manisha Desai, Juyan Zhou
1Division of Infectious Diseases, Department of Pediatrics, Columbia University, New York, New York 10032, USA.
Insights
Healthcare professionals (HCPs) show low adherence to Cystic Fibrosis (CF) infection control guidelines due to awareness and self-efficacy barriers. Improved education and support are needed to enhance CF patient care.
Area of Science:
- Infection Control in Healthcare Settings
- Cystic Fibrosis Patient Management
- Health Behavior and Adherence Research
Background:
- The American Cystic Fibrosis (CF) Foundation released evidence-based infection control guidelines in 2003.
- Understanding barriers to guideline adherence among healthcare professionals (HCPs) is crucial for effective CF patient care.
Purpose of the Study:
- To assess potential barriers to adherence to 2003 CF infection control guidelines.
- To explore knowledge, attitudes, and practices of HCPs regarding CF infection control.
Main Methods:
- A knowledge, attitude, and practice survey was administered to 528 HCPs at 25 US CF centers.
- The survey covered adherence to guidelines on quarterly cultures, patient socialization, hand hygiene, nebulizer cleaning, and room disinfection.
- Data were collected from April 2004 to December 2005.
Main Results:
- Awareness of the guidelines was limited (60%), with significant unfamiliarity with specific recommendations (31-47%).
- Self-reported adherence was low, with only 23-63% practicing guidelines consistently.
- Lack of self-efficacy was a common barrier; guideline accessibility correlated with increased agreement and self-efficacy.
Conclusions:
- Targeted strategies are necessary to overcome barriers to CF infection control guideline adherence.
- Quality improvement initiatives, enhanced education, skills workshops, and sharing best practices can improve adherence.
- Linking adherence to improved patient outcomes may further incentivize compliance.
Background:
In 2003, the American Cystic Fibrosis (CF) Foundation published revised, evidence-based guidelines for infection control. We sought to assess potential barriers to adherence to these guidelines experienced by health care professionals (HCPs) caring for CF patients.
Methods:
From April 2004 to December 2005, a knowledge, attitude, and practice survey was administered to HCPs at randomly selected CF centers in the United States to explore potential barriers to adherence to selected guidelines: (1) obtaining quarterly cultures from CF patients, (2) discouraging socialization among CF patients during hospitalization, (3) educating patients and families about hand hygiene, (4) educating patients and families to clean and disinfect home nebulizers, and (5) cleaning the clinic exam rooms between CF patients.
Results:
The survey was completed by 528 HCPs from 25 sites (5-50 respondents per site). Only 60% of respondents were aware of the guidelines, but despite awareness, 31-47% were unfamiliar with the specific guidelines. Self-reported adherence was low; only 23-63% of respondents reported practicing the selected guidelines >75% of the time/opportunities. Lack of self-efficacy, that is, confidence in adequately performing the guidelines, was commonly experienced by respondents. Access to a copy of the guidelines was associated with increased agreement with the recommendations and increased self-efficacy.
Conclusions:
Strategies to reduce barriers to adherence to CF infection control guidelines are needed. Strategies could include quality improvement initiatives with enhanced education and skills workshops, sharing successful interventions among CF centers, and linking adherence to improved patient outcomes.
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