護理人員對多重抗藥性細菌感染管制行為的相關因素探討-以南部某地區醫院為例

An investigation of knowledge, attitude, practices and related factors of infection control for multiple-drug resistant bacteria among nurses in a southern regional hospital

蘇美曲(Mei-Chu Su)

指導教授 ： 廖梨伶 ； 賴苡汝

義守大學/管理學院/管理碩博士班/碩士(2017年)

摘要

多重抗藥性細菌會造成醫療體系在使用抗生素的重大挑戰，也是當前重要的議題之一，而減少多重抗藥性細菌的方法，除了在抗生素使用的慎選外，對其感染管制確實遵守，也是非常重要的。本研究的目的是探討護理人員對多重抗藥性細菌感染管制的認知、態度及行為現況及其影響因素。收案期間自2015年3月1日至31日，利用自編結構式問卷進行調查，調查內容包括性別、工作年資、知識、態度及對多重抗藥性細菌感染管制行為，研究對象為南部某地區之護理人員，需有照顧感染多重抗藥性細菌病人之經驗，問卷發出150份，回收143份，回收率95.3％。
統計分析方法包括描述性統計及多元迴歸分析。研究結果發現：護理人員對多重抗藥性細菌感染管制的認知，答對率最高的部份為照護防護措施，而在環境及儀器清潔消毒的部份答對率最低；在態度方面，雖然有40%的護理人員認為執行感染管制措施是件麻煩的事，也認為依照感染管制要求洗手在臨床實務上很難落實，但整體調查結果是呈現積極正向的態度；而行為的執行落實程度自評皆在75%以上，但仍會因太忙或忘記而忽略非照護病人的感染管制相關工作；多元迴歸分析結果發現護理人員的多重抗藥性細菌感染管制認知對行為有顯著的影響，整個模式可解釋行為的總變異量18.2%，而認知構面中的政策也可預測行為，整個預測模式可解釋行為的總變異量之28.2%。本研究結果可提供相關單位未來在制訂多重抗藥性細菌感染管制政策及擬定教育訓練計畫之參考。

關鍵字

多重抗藥性細菌感染管制 ； 認知 ； 態度 ； 行為

並列摘要

Multiple-drug resistant bacteria can cause significant challenges in the use of antibiotics in the healthcare system. The method of reducing multiple-drug resistant bacteria is to carefully select antibiotics for medical uses as well as to absolutely obey the regulations of infection control. This study aims to investigate the status of cognition, attitude and behavior of infection control for multiple-drug resistant bacteria among nurses, as well as to figure out predictors of the behavior. Convenience sampling was adopted, and voluntary nurses from a regional hospital in South Taiwan were recruited to participate in this study. Data was collected in March 2015 using a self-developed structured questionnaire. Components of the questionnaire included general information, cognition, attitude, and behavior of infection control for multiple-drug resistant pathogens. A total of 150 questionnaires were distributed, and 143 valid questionnaires were returned, yielding a response rate of 95.3%.
Statistical methods include descriptive statistics and multiple regression. Findings of this study include: (1) The top rate of correct responses in the cognition of infection control for multiple-drug resistant bacteria among nurses fell on the part of care protection measures, while the lowest rate fell on the part of clean and disinfected environment and equipment. (2) Although approximate 40% of nurses believed that the implementation of infection control measures was a matter of trouble and that in accordance with infection control requirements of hand-washing in clinical practices was difficult to implement, the overall survey results of attitude was positive. (3) Although self-evaluated results of behavior practices were higher than 75% out of 100% practices, nurses would sometimes ignore infection control tasks that were not directly related to patient care due to being busy or forgotten. (4) Results of multiple regression analysis showed that infection control cognition of nurses regarding multiple-drug resistant bacteria could significantly predict their behavior practices, accounting for 18.2% of total variance. Results of this study can provide a reference for relevant administrative units in the development of multiple-drug resistant bacteria infection control policy and in the development of education and training programs.

並列關鍵字

infection control for multiple-drug resistant bacteria ； cognition ； attitude ； behavior

參考文獻

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