Abstract Background This study aims to explore the varied experiences of patients with drug-resistant tuberculosis in Norway. The study emphasizes challenges and implications of being diagnosed with ...drug-resistant tuberculosis, including the impact on psychosocial health during the diagnosis, disease, treatment, isolation and recovery phases. Norway is a low endemic country of tuberculosis. Most patients are immigrants, and some of them have recently arrived in the country. Patients undergoing treatment for drug-resistant tuberculosis endure prolonged and demanding treatment that could affect their psychosocial health. Methods This qualitative study conducted 16 in-depth interviews with individuals aged 18 years and above who were diagnosed with drug-resistant tuberculosis. All participants completed the treatment between 2008 and 2020. Fourteen participants were immigrants, and eight of them had resided in Norway for less than four years before diagnosis. Data analysis followed the six-phase reflexive thematic analysis framework, focusing on identifying patterns in participants’ experiences, thoughts, expectations and attitudes. Results The narratives of the participants highlighted the complexities of navigating the diagnosis of drug-resistant tuberculosis, treatment, side effects and life after treatment. Immigrants encountered additional challenges, including language barriers and adapting to new social environments. All participants reported experiencing physical health issues that additionally affected their mental health and social activity. Several participants had a delayed or prolonged diagnosis that complicated their disease trajectory. Participants with suspected or confirmed contagious pulmonary tuberculosis underwent hospital isolation for periods ranging from weeks to six months. The participants reported mental health issues, social isolation and stigma, however few were offered follow-up by a psychologist. Many participants had persistent problems at the time of the interviews. Three main themes emerged from the analysis: Delayed and prolonged diagnosis; Psychosocial impact of isolation during treatment; The life after tuberculosis. Conclusion This study highlights the enduring impact of drug-resistant tuberculosis on patients and the significance of timely diagnosis, psychosocial support and post-treatment follow-up. The participants universally faced serious implications of the disease, including stigma and isolation. Participants who experienced delayed diagnosis, reflected on missed early intervention opportunities. We recommend further research in low endemic countries to evaluate the international and local recommendations on psychosocial support.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Aims and objectives
To observe student nurses’ overall and moment‐specific hand hygiene compliance during clinical placement.
Background
Hand hygiene is the single most important measure to prevent ...healthcare‐associated infections. However, research has shown low compliance among healthcare workers. During clinical placements, student nurses perform various nursing tasks and procedures to a large number of patients, requiring extensive patient contact. It is crucial that they practice correct hand hygiene to prevent healthcare‐associated infections.
Design
Open, standardised and nonparticipating observations.
Methods
Twenty‐nine student nurses were observed three times for 20 ± 10 min during clinical placement in a Norwegian university hospital. To measure compliance, we used WHO's Hand Hygiene Observation tool, based on the model “My five moments for hand hygiene”.
Results
Overall hand hygiene compliance in the student group was 83.5%. Highest moment‐specific compliance was after touching patient surroundings, after touching patients and after body fluid exposure risk. Lowest moment‐specific compliance was recorded before touching patients or patient surroundings, and before clean/aseptic procedures.
Conclusions
Nurse education needs to be improved both theoretically and during clinical placements in order to advance and sustain compliance among student nurses.
Relevance to clinical practice
Increasing healthcare workers’ compliance with hand hygiene guidelines remains a challenge to the clinical community. In order to reduce healthcare‐associated infections, it is important to educate student nurses to comply with the guidelines during clinical placements. Identifying student nurses’ hand hygiene performance is the first step towards developing teaching methods to improve and sustain their overall and moment‐specific compliance. As a measure to ensure student compliance during clinical placements, mentors should be aware of their influence on students’ performance, act as hand hygiene ambassadors, encourage students to comply with established guidelines and provide regular feedback.
En betydelig del av sykepleierutdanningen foregår i de kliniske studiene, veiledet av sykepleiere. Denne studien er utført for å forstå studentopplevelsene, hvordan de lærer å bruke håndhygieniske ...prinsipper i kliniske studier. Vi brukte et beskrivende og utforskende design med fokusgruppeintervjuer. Dataene ble analysert ved hjelp av kvalitativ innholdsanalyse. Analysen resulterte i to hovedtemaer, både faktorer som fremmet og hemmet studentlæring. Tydelige retningslinjer prosedyrer samt støttende og oppmuntrende tilbakemeldinger fra veiledere fremmet læring. Mangel på håndhygienefasiliteter, tidspress, komplekse læringssituasjoner, tilstrekkelig anerkjennelse og veiledernes manglende overholdelse, var hemmende faktorer. Studien viser at sykepleiere i klinisk praksis var forbilder for studentene og viktig for å lære de riktige håndhygieniske prinsipper i klinisk praksis
En betydelig del av sykepleierutdanningen foregår i de kliniske studiene, veiledet av sykepleiere. Denne studien er utført for å forstå studentopplevelsene, hvordan de lærer å bruke håndhygieniske ...prinsipper i kliniske studier. Vi brukte et beskrivende og utforskende design med fokusgruppeintervjuer. Dataene ble analysert ved hjelp av kvalitativ innholdsanalyse. Analysen resulterte i to hovedtemaer, både faktorer som fremmet og hemmet studentlæring. Tydelige retningslinjer prosedyrer samt støttende og oppmuntrende tilbakemeldinger fra veiledere fremmet læring. Mangel på håndhygienefasiliteter, tidspress, komplekse læringssituasjoner, tilstrekkelig anerkjennelse og veiledernes manglende overholdelse, var hemmende faktorer. Studien viser at sykepleiere i klinisk praksis var forbilder for studentene og viktig for å lære de riktige håndhygieniske prinsipper i klinisk praksis
Bakgrunn: Sentralvenøse katetre (SVK) er et tilbud til mange pasientgrupper når det foreligger indikasjoner. Dette medfører at SVK håndteres av helsepersonell på alle enheter i helsetjenesten. ...Samtidig som SVK er livgivende, kan anvendelse av katetre i blodbanen resultere i alvorlige blodbaneinfeksjoner (SVK-BBI). Blodbaneinfeksjoner assosiert med innleggelse og håndtering av SVK, er en av de alvorligste komplikasjonene som kan oppstå. Fokus på forebygging av SVK-BBI har spredd seg fra å gjelde intensivavdelinger tilå gjelde hele helsetjenesten. Hensikten med denne studien erå se på etterlevelse av infeksjonsforebyggende retningslinjer for å forebygge SVK-BBI utenom intensivavdelinger. Fokuseropplæring, aseptisk teknikk, håndhygiene ogdesinfeksjon av koblingene. Metode: Studien er en tverrsnittsstudie hvor det gjennomføres observasjoner av etterlevelse av håndtering og stell av SVK,samten spørreundersøkelse som kartlegger opplæringav helsepersonelli forhold tildette. 40 sykepleiere deltar i observasjonsstudien og 112 helsepersonelldeltar i spørreundersøkelsen. Hovedresultat: Etterlevelse av aseptisk teknikk under prosedyre var 72,5 %.Etterlevelse av håndhygiene før SVK-prosedyre var 42%. Etterlevelse av desinfeksjon før tilgang/ skifte av koblinger var 89,6 %. 96 % av desom håndterte SVK,har fått opplæring. 68 % er opplært med multimodale metoder. Konklusjon: Studien viser at defleste som håndterteSVK har hatt opplæring. Kommentarene til spørreundersøkelsen viser likevel at det etterlyses bedre opplæring hvor praktisk trening og oppdatering av kunnskap er vektlagt. Til tross for stort fokus på opplæring viser observasjonene av etterlevelse av SVK-prosedyren at vesentlige infekjsonsforebyggende tiltak svikter.
Background:Central venous catheters (CVCs) are usedfor a wide range of indications and handled by health care professionals throughout the hospital. While CVCsare life-giving, their use may result in serious bloodstream infections. Catheter-related bloodstream infections (CRBSIs) are among the most serious complications in health care. Consequently, hospitals now focus on CRBSIs prevention throughout the entire hospital. Aim. The purpose of this study is to look at adherence to infection control guidelines for preventing CRBSIs outside intensive care units. Studied issues are education/ training of health care workers, aseptic technique, hand hygiene and disinfection of the hubs/ connections prior to use. Method.This cross-sectional study aimed to observe guideline compliance by 40 nurses during handling procedures and care of CVCs. We also conducted a sample survey of healthcare workers (n=112) to map the training of healthcare workers handling CVCs. Main results. Adherence to aseptic technique during the procedure was 72.5%, and compliance with hand hygiene before CVCs procedure was 42%. Compliance with use of disinfectant prior to access/change of hubs/connections was 89.6%. The survey revealed that 96% of respondents had been trained in properly handling CVCs; 68 % were trained with multimodal methods. Conclusion. Most healthcare workers were trained to handle CVCs. Some workers requested better training that emphasizes practical issues and updated knowledge. Despite a strong focus on education/training, our observations show that many healthcare workersremain noncompliant in CVC procedure
ISBN 978-91-86739-76-8
