How do Clostridium difficile infections affect nurses’ everyday hospital work: A qualitative study

This qualitative study explored the impact of Clostridium difficile infections on nurses’ everyday work in the hospital. Twelve nurses (six in France and six in the United States) were interviewed in depth using a semi‐structured interview guide. Thematic analysis of the interviews was performed. Managing diarrhoea and taking precautionary measures for infection control were the two most inconvenient aspects nurses reported with C. difficile patient management. Precautions included contact isolation, hand hygiene and reorganization/coordination of nursing care and ward. Precautions were time consuming and significantly increased nurses’ workload when combined with caring for patients with uncontrollable, frequent bouts of diarrhoea. Management of C. difficile infection is extremely burdensome for nurses in their everyday work and disruptive to hospital organizations as a whole. Prevention of C. difficile infections, together with coordinated team work and communication, would therefore contribute to decreasing nurses’ workload and the burden to health‐care facilities associated with caring for these patients.     

What is the relationship between nurses’ attitude to evidence based practice and the selection of wound care procedures?

Aim. To investigate qualified nurses’ attitudes to evidence‐based practice and whether this influenced their selection of wound care products. Background. The literature shows that previous studies on attitudes to evidence‐based practice tended to be part of a wider study. The general consensus was that there was a positive attitude to evidence‐based practice. However, there appeared to be no published studies specifically addressing nurses’ attitudes to evidence‐based wound care. Design. Survey design using a questionnaire completed by 156 qualified nurses working in three UK National Health Trusts. Results. A statistically significant difference was seen between those nurses with a tissue viability link nurse role (p = 0·002) and those without a link nurse role; those educated to first degree (p < 0·001) and those without a first degree; and those who had received formal tissue viability training (p < 0·001) and those with informal tissue viability training. There was also a highly statistically significant relationship between the clinical grade of staff and the overall attitude to evidence‐based practice (p < 0·001). Conclusions. Nurses who had attained a higher level academic qualification, had a tissue viability link nurse role and those who had received formal tissue viability training scored generally higher in the wound care knowledge tests and in attitude to evidence‐based practice. Relevance to clinical practice. The care received by patients in relation to wound care could be dependent upon factors that are related to the individual characteristics of the nurse providing the care and these factors, in turn, are related to education and training with respect to wound care. Better general education and better specific training in wound care could lead to better wound care.