| Objective:To clarify the gap between the current situation and guidelines of the prevention and control of multidrug-resistant organism among nurses in the department of the high incidence of multidrug-resistant organism in 3A-level comprehensive hospital of Shanxi Province,and to explore the application effect of the transtheoretical model of behavior in the prevention and control practice of multidrug-resistant organism in nurses,and to provide practical basis for the prevention and control of multidrug-resistant organism in the future.Contents and Methods:The survey research: From July 1,2018 to July 31,2018,a questionnaire on practice status of prevention and control of multidrug-resistant organism and a questionnaire on prevention and control behavior stage of multidrug-resistant organism were used to investigate the nurses in 8 of 3A-level comprehensive hospitals in 6 prefectural cities of Shanxi Province.Electronic questionnaire was used in this study,a total of 502 questionnaires were collected,489 of which were valid,with an effective response rate of97.41%.The quasi-randomized controlled trial: On August 1,2018-November 30,2018,convenience sampling was used to select 2 of 3A-level comprehensive hospitals in Shanxi Province.According to the principle of cluster sampling,37 nurses who conform to the inclusion and exclusion criteria in the neurosurgery department of one hospital were selected as the intervention group,and 34 nurses who conform to the inclusion and exclusion criteria in the neurosurgery department of the other hospital were selected as the control group.The intervention group carried out the intervention program guided by the transtheoretical model of behavior,while the control group carried out routine intervention.A questionnaire on practice status of prevention and control of multidrug-resistant organism,a questionnaire on prevention and control behavior stage of multidrug-resistantorganism,self-efficacy scale,hand hygiene watch list respectively were used to measure the two groups nurses' behavior scores,behavior stages,self-efficacy scores,hand hygiene compliance rate,hand hygiene accuracy rate at before the intervention,the first month after the intervention,and the second month after the intervention.Through horizontal and vertical comparison,the effect of the transtheoretical model of behavior in the prevention and control of multidrug-resistant organism were evaluated.Results:(1)The average score of 489 nurses for the prevention and control of multidrug-resistant organism was(139.51±19.61)points.Among the 5 prevention and control measures of multidrug-resistant organism,the highest compliance of isolation measures was(32.54±4.59)points,scoring rate was 92.97%;and the lowest compliance of education and training was(21.40±4.13)points,scoring rate was 85.60%.According to the questionnaire on the prevention and control behavior stage of multidrug-resistant organism,the prevention and control behavior of 489 nurses was mainly in the contemplation stage(24.34%),the preparation stage(19.84%),the action stage(25.77%)and the maintenance stage(25.97%).(2)The results of multiple stepwise regression showed that the factors influencing the scores of nurses' prevention and control behaviors were whether they were members of the nosocomial infection management team,nurses' sense of self-efficacy in implementing the prevention and control behaviors of multidrug-resistant organism,and the prevention and control behavior stages of multidrug-resistant organism.(3)After training,both groups of nurses were undergoing positive changes in the stages of prevention and control behavior of multidrug-resistant organism,and the behavior scores,the self-efficacy scores,hand hygiene compliance rate,and hand hygiene accuracy rate were all improved.After horizontal and vertical comparison,the improvement of nurses' prevention and control behavior scores,behavior stages,self-efficacy scores,hand hygiene compliance rate and hand hygiene accuracy rate in the intervention group was significantly better than that in the control group,and the difference were statistically significant(P<0.05).Conclusion:The prevention and control practice status of multidrug-resistant organism of nurses inthe department of the high incidence of multidrug-resistant organism in the 3A-level comprehensive hospitals of Shanxi Province are above the average level,but there is still a gap with the requirements of the prevention and control guidelines.The transtheoretical model of behavior can promote the positive transformation of nurses' prevention and control behaviors of multidrug-resistant organism,and improve the compliance of nurses' prevention and control behaviors of multidrug-resistant organism,which has the value of promotion in clinical practice. |
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