Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Nurses' Knowledge and Care Practices for Infection Prevention in Neutropenic Patients

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Nurses' Knowledge and Care Practices for Infection Prevention in Neutropenic Patients

Article excerpt

Background

Neutropenia is one of the most common risk factors of serious infections in immune suppressed patients. Neutropenia-associated infections can prolong hospitalization, increase re-admission, mortality and morbidity rates (Agyeman et al., 2014; Moon & Chun, 2009; Rosa & Goldani, 2014; Sacar, Kabukcu Hacioglu, Keskin, & Turgut, 2008). The financial cost of hospitalizations due to a neutropenia-associated infection episode has been reported to range from US$2549 to US $7879 (Chindaprasirt et al., 2013; Schelenz, Giles, & Abdallah, 2012; Teuffel, Amir, Alibhai, Beyene, & Sung, 2011; Wang, Wong, Hsu, & Chan, 2014) while the risk for death from infection-related complications ranges approximately from 3.6% to 21.05% (Chindaprasirt et al., 2013; Kuderer, Dale, Crawford, Cosler, & Lyman, 2006; Moon & Chun, 2009; Okera et al., 2010; Sacar et al., 2008). In addition to those global effects, patients and families experience social life restrictions, feelings of uncertainty about future, dealing with work/professional life challenges, and anxiety about changes in treatment/care plan (Fortner, Tauer, Okon, Houts, & Schwartzberg, 2005; Padilla & Ropka, 2005).

Despite the fact that neutropenia result in infections, multiple preventive treatment and care protocols are proven to reduce the infection rates, and improve quality of life (Padilla & Ropka, 2005; White, Maxwell, Michelson, & Bedell, 2005). The healthcare team but especially nurses are taking main responsibility of those types of protocols. In this context nurses, who are in close contact with patients, are expected use their evidence based knowledge and skills to plan and provide individualized care (Freifeld et al., 2011).

Literature showed that nurses' knowledge about neutropenia and neutropenic patients care is inadequate (Abbasoglu, 1997; Ertem, 2004; Foubert, Kearney, Ouwerkerk, Uhlenhopp, & Vaessen, 2005). Foubert et al. (2005) reported that 37.4% of nurses did not give correct answer to questions related with the absolute neutrophil count at first cycle which is the strongest predictor of neutropenia and only 21.3% of them gave correct answer to the critical range of neutrophil count for neutropenia. Abbasoglu (1997) reported that only 6.9% of the nurses' knowledge score was higher than the expected mean score. Those limited study results indicated that nurses having a problem relating with theoretical background of neutropenia or care of patients with it, but among these there is scarce studies investigating how nurses' transfer their knowledge into their care practices.

The studies conducted to determine nurses', healthcare workers' or students' knowledge, attitudes, and practices were mostly focused on infections, infection control practices, hand hygiene etc.(Iliyasu et al., 2016; Nair, Hanumantappa, Hiremath, Siraj, & Raghunath, 2014; Ogoina et al., 2015; Sarani, Balouchi, Masinaeinezhad, & Ebrahimitabs, 2016; Teshager, Engeda, & Worku, 2015). Iliyasu et al. (2016) founded that the median overall percent knowledge and practice of infection control scores were 70.0% and 65.0%, respectively and there was a weak negative correlation between overall percent knowledge score and overall percent practice score. Ogoina et al. (2015) found that the health workers' median knowledge and attitude scores toward standard precautions were above 90.0%, but median practice score was 50.8%. Sarani et al. (2016) showed that only 22.0% of nurses had good knowledge and 34.0% had good practice about standart precautions for hospital-acquired infections. In another study researchers reported that even nursing students had better practice (62.1%) compared to medical students (19.6%) and they totally had moderate knowledge (74.0%) about hand hygiene (Nair et al., 2014). Teshager et al. (2015) showed that more than half of the nurses had inadequate knowledge about the prevention of surgical site infections (56. …

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