Clostridium difficile infection perceptions and practices: a multicenter qualitative study in South Africa

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dc.contributor.authorLegenza, Laurel
dc.contributor.authorBarnett, Susanne
dc.contributor.authorRose, Warren
dc.contributor.authorSafdar, Nasia
dc.contributor.authorEmmerling, Theresa
dc.contributor.authorHee Peh, Keng
dc.contributor.authorCoetzee, Renier
dc.date.accessioned2018-11-05T08:05:14Z
dc.date.available2018-11-05T08:05:14Z
dc.date.issued2018
dc.description.abstractBACKGROUND: Clostridium difficile infection (CDI) is understudied in limited resource settings. In addition, provider awareness of CDI as a prevalent threat is unknown. An assessment of current facilitators and barriers to CDI identification, management, and prevention is needed in limited resource settings to design and evaluate quality improvement strategies to effectively minimize the risk of CDI. METHODS: Our study aimed to identify CDI perceptions and practices among healthcare providers in South African secondary hospitals to identify facilitators and barriers to providing quality CDI care. Qualitative interviews (11 physicians, 11 nurses, 4 pharmacists,) and two focus groups (7 nurses, 3 pharmacists) were conducted at three district level hospitals in the Cape Town Metropole. Semi-structured interviews elicited provider perceived facilitators, barriers, and opportunities to improve clinical workflow from patient presentation through CDI (1) Identification, (2) Diagnosis, (3) Treatment, and (4) Prevention. In addition, a summary provider CDI knowledge score was calculated for each interviewee for seven components of CDI and management. RESULTS: Major barriers identified were knowledge gaps in characteristics of C. difficile identification, diagnosis, treatment, and prevention. The median overall CDI knowledge score (scale 0–7) from individual interviews was 3 [interquartile range 0.25, 4.75]. Delays in C. difficile testing workflow were identified. Participants perceived supplies for CDI management and prevention were usually available; however, hand hygiene and use of contact precautions was inconsistent. CONCLUSIONS: Our analysis provides a detailed description of the facilitators and barriers to CDI workflow and can be utilized to design quality improvement interventions among limited resource settings.en_US
dc.identifier.citationLegenza, L. et al. (2018). Clostridium difficile infection perceptions and practices: a multicenter qualitative study in South Africa. Antimicrobial Resistance and Infection Control, 7: 125en_US
dc.identifier.issn2047-2994
dc.identifier.urihttps://doi.org/10.1186/s13756-018-0425-y
dc.identifier.urihttp://hdl.handle.net/10566/4182
dc.language.isoenen_US
dc.privacy.showsubmitterFALSE
dc.publisherBMCen_US
dc.rights© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
dc.status.ispeerreviewedTRUE
dc.subjectHealthcare associated infectionen_US
dc.subjectInfection controlen_US
dc.subjectQualitative studyen_US
dc.subjectAntimicrobial stewardshipen_US
dc.subjectGlobal healthen_US
dc.titleClostridium difficile infection perceptions and practices: a multicenter qualitative study in South Africaen_US
dc.typeArticleen_US

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