Somebody else’s problem: Staff perceptions of MRSA

It has become increasingly clear that MRSA is a significant health challenge for the present and the future. Not only does it kill more people each year than AIDS in the US, but it is also a significant source of unnecessary patient pain and suffering. In Britain, the National Health Service has recorded a spike in contamination and infection rates, going from 2% in 1990, to 43% in 2002.

One of places currently undergoing major transitions in order to adapt to the growing problem of MRSA is the hospital environment. Here, the key element is the staff responsible for day-to-day operations concerning MRSA, namely, the health personnel. Previous studies done in this area have tended to ascribe the high incidence of MRSA infection in hospitals to a lack of staff knowledge on the subject. However, this theory has proved insufficient.

In a 2011 study, Elizabeth Morrow, Peter Griffiths, G. Gopal Rao, and Debbie Flaxman examined the relationship between infection control and the attitudes of hospital staff. More specifically, attitudes that tended to attribute the causes of MRSA to forces outside the hospital (such as senior care centers, communities, etc) or to incontrollable conditions within the hospital itself.

They observed three main issues:

1) Information problems: The study found significant differences in how healthcare workers determined the causes of rising MRSA infection rates. This implies that the knowledge of infection control practices also varies between organizations.

2) Lack of ownership: The researchers observed a tendency for hospital staff to either underestimate the risks of MRSA transmissions in their own environment, attributing the cause to other factors, or when they did admit internal risks they pointed to incontrollable internal factors, thereby diminishing personal responsibility.

3) Quality differences: Good group morale and solidarity can do two things. On one hand, it can lead a team to contest poor practices and deficiencies. On the other hand, it can also lead the team to distance itself from failing parts of the healthcare system. This in turn leads back to the variations between infection control practices.

The most important finding in this study seems to relate to perceptions about MRSA causes. Indeed, during the research process, it was observed that healthcare workers seemed to estimate the prevalence of MRSA as lower within their own institutions, as compared to others. For example, hospital staff tended to identify community sources, whereas care home staff identified hospitals. Staff in both settings claimed to be informed about MRSA. Oddly, despite their differences, both had similar claims:

  • Lack of knowledge concerning a patient’s infection status is detrimental to their infection control practices.
  • Uncertainty about where a patient contracts MRSA makes it all the more difficult for either party to take ownership of the problem as being caused by their own practices.

Finally, the study concluded that infection control teams and unit managers will have a key role to play in mediating between various health organizations, in order to create a unified strategy to combat MRSA infection. Recent campaigns to control infections within hospitals have been extremely successful. However, more efforts may have to be made in order to coordinate between the network of organizations needed to effectively stem the spread of MRSA.

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