The lived experience of haemodialysis patients managed with transmission-based precautions for MDRO colonisation: A qualitative study

Article

Gray, Nicholas A., Toy, Lisa, Dalla-Bona, Kim, Broom, Jennifer and Gray, Marion. 2022. "The lived experience of haemodialysis patients managed with transmission-based precautions for MDRO colonisation: A qualitative study." Infection, Disease and Health. 27 (4), pp. 211-218. https://doi.org/10.1016/j.idh.2022.05.003
Article Title

The lived experience of haemodialysis patients managed with transmission-based precautions for MDRO colonisation: A qualitative study

ERA Journal ID15767
Article CategoryArticle
AuthorsGray, Nicholas A., Toy, Lisa, Dalla-Bona, Kim, Broom, Jennifer and Gray, Marion
Journal TitleInfection, Disease and Health
Journal Citation27 (4), pp. 211-218
Number of Pages8
Year2022
PublisherElsevier
Place of PublicationUnited Kingdom
ISSN1835-5617
1835-5625
2468-0451
Digital Object Identifier (DOI)https://doi.org/10.1016/j.idh.2022.05.003
Web Address (URL)https://www.idhjournal.com.au/article/S2468-0451(22)00025-6/fulltext
Abstract

Background
Patients undergoing haemodialysis colonised with multi-drug resistant organisms (MDROs) are commonly managed with transmission-based precautions (TBP) to prevent nosocomial transmission. TBP have been linked to mixed effects on patient psychological well-being and clinical care. This study was designed to report the lived experience of dialysis patients managed with TBP.
Methods
A qualitative study of 15 patients undergoing haemodialysis managed with TBP was performed. Participants took part in individual semi-structured interviews. Data was analysed utilising an interpretive phenomenological approach.
Results
Four themes were identified.
1. Communication of what MDRO screening meant, the results, and implications of MDRO positivity was perceived by many patients as insufficient and inconsistent.
2. Experiences of care in isolation were described, with both positive (privacy) and negative (reduced interaction) experiences identified.
3. Psychosocial and emotional responses including concern about health implications and stigma were reported, but also screening was described by some as increasing their perception of being cared for by health care workers, as they felt all health risks were being managed.
4. Confusion around perceived inconsistencies of management, particularly across different environments (eg hospital vs home) and staff.
Conclusion
TBP have complex positive and negative impacts on patients which should be considered when developing MDRO management policy and communication around such policy. Strategies to improve communication, patient and staff education, and remove (or explain) perceived inconsistencies of practice may reduce the negative consequences of TBP leading to improved delivery of quality, person-centred care.

KeywordsMulti-drug resistant organisms Isolation ; Haemodialysis ; Transmission-based precautions; Health communication; Patient experience
ANZSRC Field of Research 2020420602. Health equity
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Byline AffiliationsSunshine Coast University Hospital, Australia
University of the Sunshine Coast
Sunshine Coast Health Institute, Australia
University of Southern Queensland
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