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Home-based nursing care for clients carrying multidrug-resistant organisms: A focus group study in the Netherlands
Tessa J C Langeveld1, Manon R Haverkate2, Renske Eilers2
1Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), 3720 BA Bilthoven, Netherlands; Athena Institute, Faculty of Science, Vrije Universiteit (VU), WN-C553, 1081 HV Amsterdam, Netherlands.
Background:
The growing population of vulnerable clients receiving home-based nursing care (HBNC), combined with the worldwide increase in the prevalence of multidrug-resistant organisms (MDROs), poses a new burden on nursing staff. This study explored the attitudes, perceptions, experiences, challenges, and needs of nursing staff providing HBNC for clients carrying MDROs.
Methods:
Seven focus groups with home-based nursing staff (N = 34) were performed in the Netherlands between April and July 2022, using a semistructured, open-ended topic list based on the integrated-change model and seven domains of practice. Data were analyzed using thematic analysis.
Results:
Participants experienced ambiguities in infection prevention and control recommendations in MDRO guidelines or protocols. At times, the proportionality of these measures was questioned, including the effect on compliance. Participants indicated to be influenced by perceptions and behavior of their colleagues and clients. Furthermore, participants experienced inadequate information exchange about MDRO carriage and debated about the roles and responsibilities of involved health care professionals.
Conclusions:
There is a need for tailored MDRO guidelines for HBNC. Expanding knowledge, sufficient resources, and improving information exchange about MDRO carriage among health care professionals, clients (including their family members), and HBNC organization boards are essential to respond to current developments in HBNC.
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