Nursing knowledge and methicillin resistant Staphylococcus aureus : implications for community health nursing in First Nations communities [research project] / by Cheryl A. Chisholm.

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a serious nosocomial and community-associated pathogen in aboriginal people in Canada (Canadian Pediatric Society, 2005). A recent survey with First Nations employed community health nurses (CHNs) in the Atlantic region found that nursing knowledge is lowest in the area of emerging infections such as MRSA (Mi’kmaq Confederacy of Prince Edward Island, 2009). The objective of this project is to review the nursing literature on this topic and to describe the factors that contribute to low nursing knowledge of MRSA. A search of the literature published during 2000-2008 using Medline, CINAHL with full text, DARE, and CDSR was conducted using the following search terms: “community-acquired MRSA”, “hospital-associated MRSA”, “hospital acquired MRSA”, “community-associated MRSA”, “MRSA”, “community health nursing”, “nurse” “nursing”, “antibiotic resistant organisms”, “nosocomial infections” and “knowledge”. The search generated 48 papers for review. For each paper, information was obtained on the study population, health care setting (acute or community), geographic location of the research, and the study type. Publications were sorted by topic area MRSA (CA-MRSA, HA-MRSA or both) or nosocomial infections. The articles were also organized into key theme areas for further description. Sixty-two and one half percent (30) of the papers referred to healthcare workers as the study population (nurses, doctors, aides, dentists). Nurses were the primary study population in 37.5% (18) of the papers, with only three of these papers focused on community health nurses. The research in this area has emerged from the United Kingdom (37.5%) and the United States (35%), with a paucity of research on this topic in Canada (15%) and the rest of the world. Sixty-two and one half percent of the papers focused on MRSA with two of the papers discussing CA-MRSA, Thirty-seven and one half percent of the papers focused on the broader topic of nosocomial infections. Acute care is the most common setting for research in this area (73%). Only five articles were found on this topic in a community setting. The majority of literature available addresses MRSA knowledge deficits and strategies to address them. There is limited literature published on the factors contributing to low nursing knowledge of MRSA. The review suggests that a gap exists in infection control content in nursing curriculum at the undergraduate level and between nurses’ reported knowledge and practice. The review also suggests that nurses’ personal way of knowing contributes to their knowledge ofMRSA. Further research is required on these factors. Additional research on this topic is needed in Canada and in a variety of nursing practice settings. Nurses employed in First Nations communities warrant increased attention considering the implications of MRSA in aboriginal people.