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Staff experiences of caring for patients with extended-spectrum β-lactamase–producing bacteria: A qualitative study

  • Susanne Wiklund
    Correspondence
    Address correspondence to Susanne Wiklund, RN, MPH, PhD, Department of Infection Control and Hospital Hygiene, Stockholm County Council and Department of Medicine, Solna (MedS), Unit of Infectious Diseases, Karolinska Institutet, Stockholm, Sweden. Stockholm South General Hospital, Jägargatan 20, SE 118 83 Stockholm, Sweden.
    Affiliations
    Department of Infection Control and Hospital Hygiene, Stockholm County Council, Stockholm, Sweden

    Department of Medicine, Solna (MedS), Unit of Infectious Diseases, Karolinska Institutet, Stockholm, Sweden
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  • Ingegerd Fagerberg
    Affiliations
    Department of Healthcare Sciences, Ersta Sköndal University College, Stockholm, Sweden

    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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  • Åke Örtqvist
    Affiliations
    Department of Medicine, Solna (MedS), Unit of Infectious Diseases, Karolinska Institutet, Stockholm, Sweden

    Department of Communicable Disease Control and Prevention, Stockholm County Council, Stockholm, Sweden
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  • Kristina Broliden
    Affiliations
    Department of Medicine, Solna (MedS), Unit of Infectious Diseases, Karolinska Institutet, Stockholm, Sweden

    Karolinska University Hospital and Center for Molecular Medicine, Stockholm, Sweden
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  • Ann Tammelin
    Affiliations
    Department of Infection Control and Hospital Hygiene, Stockholm County Council, Stockholm, Sweden

    Department of Medicine, Solna (MedS), Unit of Infectious Diseases, Karolinska Institutet, Stockholm, Sweden
    Search for articles by this author
Published:August 17, 2015DOI:https://doi.org/10.1016/j.ajic.2015.07.008

      Highlights

      • The purpose of the study was to increase the knowledge of what it means for staff in acute care settings and nursing homes to care for patients with extended-spectrum β-lactamase (ESBL)-producing bacteria.
      • The results showed that conditions varied between acute care settings and nursing homes.
      • Staff in acute care settings and nursing homes must have adequate knowledge and reasonable working conditions to be able to provide high-quality care for patients and residents who are ESBL carriers.

      Background

      Patients who become carriers of antibiotic-resistant bacteria are sometimes stigmatized by health professionals. Staff members' fears of becoming infected could affect their willingness to care for these patients.

      Methods

      The purpose of this study was to increase the knowledge of what it means for staff in acute care settings and nursing homes to care for patients with extended-spectrum β-lactamase (ESBL)-producing bacteria. Assistant nurses, registered nurses, and physicians from acute care settings and nursing homes were interviewed. A modified version of Grounded Theory was used for the analysis.

      Results

      The analysis resulted in the core category “to operate as an expert in a chaotic environment” in acute care settings. Despite a lack of resources, hospital staff try to provide the best possible care for patients with ESBL. The analysis of the interviews in the nursing homes resulted in the core category “the employee who, despite uncertainty, provides good care.” Despite some fear, and a lack of knowledge, the study participants tried to provide the residents with good care.

      Conclusion

      Staff in acute care settings and nursing homes must have adequate knowledge and reasonable working conditions to be able to provide high-quality care for patients and residents who are ESBL carriers.

      Key Words

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