Attitudes and self‐efficacy towards infection prevention and control and antibiotic stewardship among nurses: A mixed‐methods study

• Published in: Journal of clinical nursing 2023-09, Vol.32 (17-18), p.6268-6286
• Main Authors: Tangeraas Hansen, Marte Johanne, Storm, Marianne, Syre, Heidi, Dalen, Ingvild, Husebø, Anne Marie Lunde
• Format: Article
• Language: English
• Subjects: antibiotic stewardship; Antibiotics; Attitudes; Bacteria; Bacterial infections; Clinical medicine; infection control; Infection prevention and control; Infections; infectious diseases nursing; medication management; mixed methods; Mixed methods research; multidrug resistant bacteria; Multidrug resistant organisms; Nurses; Nursing care; Prevention; self‐efficacy
• ISSN: 0962-1067; 1365-2702
• DOI: 10.1111/jocn.16657

Aims To gain a comprehensive understanding of nurses' infection control practices, antibiotics stewardship attitudes and self‐efficacy when caring for patients with multidrug‐resistant bacterial infections in a hospital setting. Background Multidrug‐resistant bacteria cause a substantial health burden by complicating infections and prolonging hospital stays. Attitudes and self‐efficacy can inform professional behaviour. Nurses' attitudes and self‐efficacy concerning multidrug‐resistant bacteria, infection prevention and control and antibiotic stewardship are vital in keeping patients safe. Design A descriptive and convergent mixed‐methods design involving quantitative and qualitative approaches was used. Methods Two hundred and seventeen nurses working in clinical practice at seven different hospital wards (i.e., general medicine, surgical, haematological and oncology) at a Norwegian university hospital were invited to participate. Data were collected in February and March 2020 via two questionnaires: the Multidrug‐Resistant Bacteria Attitude Questionnaire and the General Perceived Self‐Efficacy Scale (n = 131) and four focus group interviews (n = 22). The data were analysed using descriptive statistics and systematic text condensation. Results Most nurses showed moderate knowledge, adequate behavioural intentions towards infection prevention and antibiotic stewardship, and high self‐efficacy. However, they reported negative emotions towards their knowledge level and negative emotions towards nursing care. The nurses appeared uncertain about their professional influence and role in antibiotic stewardship practices. Organisational and relational challenges and ambivalent perceptions of nurses' role were potential explanations. Conclusion Nurses report moderate attitudes and high self‐efficacy when caring for patients with multidrug‐resistant bacterial infections. This study suggests that nurses experience organisational and relational factors in their work environment that challenge their attitudes towards infection prevention and control and antibiotic stewardship practices. Measures that strengthen their knowledge and emotional response underpin correct infection prevention and control behaviour. A role clarification is needed for antibiotic stewardship. No Patient or Public Contribution. Relevance to clinical practice Measures to increase attitudes towards infection prevention and control, antibiotic stewardship and multidrug resistance is recommended. M