Barriers to adherence to cystic fibrosis infection control guidelines

Elizabeth Garber, Manisha Desai, Juyan Zhou, Luis Alba, Denise Angst, Michael Cabana, Lisa Saiman, Robert A. Kaslovsky, Scott A. Schroeder, Raj Padman, Amy Szymanski, John McNamara, Mary Sachs, David A. Hicks, Ofelia Vargas-Shiraishi, Thomas Scanlin, Howard B. Panitch, Barbara T. Jansma, William M. Gershan, Mary Ellen FreemanLynne M. Quittell, Samiya Razvi, Karen McCoy, Beth D'Antonio, Nancy N. Dambro, Janet Garbarz, Thomas Murphy, Barbara McLurkin, Kimberly Jones, Antoinette Gardner, Amanda Dove, Kathleen Buckley, Joel H. Schmidt, Andrew J. Lipton, Monica Leupold, Henry A. Wojtczak, Jerri Gray, Laurie Varlotta, Deborah Conklin, Daniel B. Rosenbluth, Jane Quante, Ran D. Anbar, Donna Lindner, Thomas Lahiri, Jackie Swartz, Paula J. Anderson, Larry Gann, Bettina Hilman, Rodolfo Amaro, Monya Rucker, Scott H. Davis, Joanna Reboul, Mary H. Wagner, Terry Spencer, Cindy Capen, Catherine Kier, Teresa Carney, Michael J. Rock, Cynthia Moodie, Dana G. Kissner, Yvette LeFlore

Research output: Contribution to journalReview article

28 Citations (Scopus)

Abstract

Background: In 2003, the American Cystic Fibrosis (CF) Foundation published revised, evidence-based guidelines for infection control. We sought to assess potential barriers to adherence to these guidelines experienced by health care professionals (HCPs) caring for CF patients. Methods: From April 2004 to December 2005, a knowledge, attitude, and practice survey was administered to HCPs at randomly selected CF centers in the United States to explore potential barriers to adherence to selected guidelines; (1) obtaining quarterly cultures from CF patients, (2) discouraging socialization among CF patients during hospitalization, (3) educating patients and families about hand hygiene, (4) educating patients and families to clean and disinfect home nebulizers, and (5) cleaning the clinic exam rooms between CF patients. Results: The survey was completed by 528 HCPs from 25 sites (5-50 respondents per site). Only 60% of respondents were aware of the guidelines, but despite awareness, 31-47% were unfamiliar with the specific guidelines. Self-reported adherence was low; only 23-63% of respondents reported practicing the selected guidelines >75% of the time/opportunities. Lack of self-efficacy, that is, confidence in adequately performing the guidelines, was commonly experienced by respondents. Access to a copy of the guidelines was associated with increased agreement with the recommendations and increased self-efficacy. Conclusions: Strategies to reduce barriers to adherence to CF infection control guidelines are needed. Strategies could include quality improvement initiatives with enhanced education and skills workshops, sharing successful interventions among CF centers, and linking adherence to improved patient outcomes.

Original languageEnglish (US)
Pages (from-to)900-907
Number of pages8
JournalPediatric Pulmonology
Volume43
Issue number9
DOIs
StatePublished - Sep 1 2008
Externally publishedYes

Fingerprint

Infection Control
Cystic Fibrosis
Guidelines
Self Efficacy
Delivery of Health Care
Hand Hygiene
Guideline Adherence
Health Knowledge, Attitudes, Practice
Education
Socialization
Nebulizers and Vaporizers
Quality Improvement
Surveys and Questionnaires
Hospitalization

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Pediatrics, Perinatology, and Child Health

Cite this

Garber, E., Desai, M., Zhou, J., Alba, L., Angst, D., Cabana, M., ... LeFlore, Y. (2008). Barriers to adherence to cystic fibrosis infection control guidelines. Pediatric Pulmonology, 43(9), 900-907. https://doi.org/10.1002/ppul.20876
Garber, Elizabeth ; Desai, Manisha ; Zhou, Juyan ; Alba, Luis ; Angst, Denise ; Cabana, Michael ; Saiman, Lisa ; Kaslovsky, Robert A. ; Schroeder, Scott A. ; Padman, Raj ; Szymanski, Amy ; McNamara, John ; Sachs, Mary ; Hicks, David A. ; Vargas-Shiraishi, Ofelia ; Scanlin, Thomas ; Panitch, Howard B. ; Jansma, Barbara T. ; Gershan, William M. ; Freeman, Mary Ellen ; Quittell, Lynne M. ; Razvi, Samiya ; McCoy, Karen ; D'Antonio, Beth ; Dambro, Nancy N. ; Garbarz, Janet ; Murphy, Thomas ; McLurkin, Barbara ; Jones, Kimberly ; Gardner, Antoinette ; Dove, Amanda ; Buckley, Kathleen ; Schmidt, Joel H. ; Lipton, Andrew J. ; Leupold, Monica ; Wojtczak, Henry A. ; Gray, Jerri ; Varlotta, Laurie ; Conklin, Deborah ; Rosenbluth, Daniel B. ; Quante, Jane ; Anbar, Ran D. ; Lindner, Donna ; Lahiri, Thomas ; Swartz, Jackie ; Anderson, Paula J. ; Gann, Larry ; Hilman, Bettina ; Amaro, Rodolfo ; Rucker, Monya ; Davis, Scott H. ; Reboul, Joanna ; Wagner, Mary H. ; Spencer, Terry ; Capen, Cindy ; Kier, Catherine ; Carney, Teresa ; Rock, Michael J. ; Moodie, Cynthia ; Kissner, Dana G. ; LeFlore, Yvette. / Barriers to adherence to cystic fibrosis infection control guidelines. In: Pediatric Pulmonology. 2008 ; Vol. 43, No. 9. pp. 900-907.
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title = "Barriers to adherence to cystic fibrosis infection control guidelines",
abstract = "Background: In 2003, the American Cystic Fibrosis (CF) Foundation published revised, evidence-based guidelines for infection control. We sought to assess potential barriers to adherence to these guidelines experienced by health care professionals (HCPs) caring for CF patients. Methods: From April 2004 to December 2005, a knowledge, attitude, and practice survey was administered to HCPs at randomly selected CF centers in the United States to explore potential barriers to adherence to selected guidelines; (1) obtaining quarterly cultures from CF patients, (2) discouraging socialization among CF patients during hospitalization, (3) educating patients and families about hand hygiene, (4) educating patients and families to clean and disinfect home nebulizers, and (5) cleaning the clinic exam rooms between CF patients. Results: The survey was completed by 528 HCPs from 25 sites (5-50 respondents per site). Only 60{\%} of respondents were aware of the guidelines, but despite awareness, 31-47{\%} were unfamiliar with the specific guidelines. Self-reported adherence was low; only 23-63{\%} of respondents reported practicing the selected guidelines >75{\%} of the time/opportunities. Lack of self-efficacy, that is, confidence in adequately performing the guidelines, was commonly experienced by respondents. Access to a copy of the guidelines was associated with increased agreement with the recommendations and increased self-efficacy. Conclusions: Strategies to reduce barriers to adherence to CF infection control guidelines are needed. Strategies could include quality improvement initiatives with enhanced education and skills workshops, sharing successful interventions among CF centers, and linking adherence to improved patient outcomes.",
author = "Elizabeth Garber and Manisha Desai and Juyan Zhou and Luis Alba and Denise Angst and Michael Cabana and Lisa Saiman and Kaslovsky, {Robert A.} and Schroeder, {Scott A.} and Raj Padman and Amy Szymanski and John McNamara and Mary Sachs and Hicks, {David A.} and Ofelia Vargas-Shiraishi and Thomas Scanlin and Panitch, {Howard B.} and Jansma, {Barbara T.} and Gershan, {William M.} and Freeman, {Mary Ellen} and Quittell, {Lynne M.} and Samiya Razvi and Karen McCoy and Beth D'Antonio and Dambro, {Nancy N.} and Janet Garbarz and Thomas Murphy and Barbara McLurkin and Kimberly Jones and Antoinette Gardner and Amanda Dove and Kathleen Buckley and Schmidt, {Joel H.} and Lipton, {Andrew J.} and Monica Leupold and Wojtczak, {Henry A.} and Jerri Gray and Laurie Varlotta and Deborah Conklin and Rosenbluth, {Daniel B.} and Jane Quante and Anbar, {Ran D.} and Donna Lindner and Thomas Lahiri and Jackie Swartz and Anderson, {Paula J.} and Larry Gann and Bettina Hilman and Rodolfo Amaro and Monya Rucker and Davis, {Scott H.} and Joanna Reboul and Wagner, {Mary H.} and Terry Spencer and Cindy Capen and Catherine Kier and Teresa Carney and Rock, {Michael J.} and Cynthia Moodie and Kissner, {Dana G.} and Yvette LeFlore",
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Garber, E, Desai, M, Zhou, J, Alba, L, Angst, D, Cabana, M, Saiman, L, Kaslovsky, RA, Schroeder, SA, Padman, R, Szymanski, A, McNamara, J, Sachs, M, Hicks, DA, Vargas-Shiraishi, O, Scanlin, T, Panitch, HB, Jansma, BT, Gershan, WM, Freeman, ME, Quittell, LM, Razvi, S, McCoy, K, D'Antonio, B, Dambro, NN, Garbarz, J, Murphy, T, McLurkin, B, Jones, K, Gardner, A, Dove, A, Buckley, K, Schmidt, JH, Lipton, AJ, Leupold, M, Wojtczak, HA, Gray, J, Varlotta, L, Conklin, D, Rosenbluth, DB, Quante, J, Anbar, RD, Lindner, D, Lahiri, T, Swartz, J, Anderson, PJ, Gann, L, Hilman, B, Amaro, R, Rucker, M, Davis, SH, Reboul, J, Wagner, MH, Spencer, T, Capen, C, Kier, C, Carney, T, Rock, MJ, Moodie, C, Kissner, DG & LeFlore, Y 2008, 'Barriers to adherence to cystic fibrosis infection control guidelines', Pediatric Pulmonology, vol. 43, no. 9, pp. 900-907. https://doi.org/10.1002/ppul.20876

Barriers to adherence to cystic fibrosis infection control guidelines. / Garber, Elizabeth; Desai, Manisha; Zhou, Juyan; Alba, Luis; Angst, Denise; Cabana, Michael; Saiman, Lisa; Kaslovsky, Robert A.; Schroeder, Scott A.; Padman, Raj; Szymanski, Amy; McNamara, John; Sachs, Mary; Hicks, David A.; Vargas-Shiraishi, Ofelia; Scanlin, Thomas; Panitch, Howard B.; Jansma, Barbara T.; Gershan, William M.; Freeman, Mary Ellen; Quittell, Lynne M.; Razvi, Samiya; McCoy, Karen; D'Antonio, Beth; Dambro, Nancy N.; Garbarz, Janet; Murphy, Thomas; McLurkin, Barbara; Jones, Kimberly; Gardner, Antoinette; Dove, Amanda; Buckley, Kathleen; Schmidt, Joel H.; Lipton, Andrew J.; Leupold, Monica; Wojtczak, Henry A.; Gray, Jerri; Varlotta, Laurie; Conklin, Deborah; Rosenbluth, Daniel B.; Quante, Jane; Anbar, Ran D.; Lindner, Donna; Lahiri, Thomas; Swartz, Jackie; Anderson, Paula J.; Gann, Larry; Hilman, Bettina; Amaro, Rodolfo; Rucker, Monya; Davis, Scott H.; Reboul, Joanna; Wagner, Mary H.; Spencer, Terry; Capen, Cindy; Kier, Catherine; Carney, Teresa; Rock, Michael J.; Moodie, Cynthia; Kissner, Dana G.; LeFlore, Yvette.

In: Pediatric Pulmonology, Vol. 43, No. 9, 01.09.2008, p. 900-907.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Barriers to adherence to cystic fibrosis infection control guidelines

AU - Garber, Elizabeth

AU - Desai, Manisha

AU - Zhou, Juyan

AU - Alba, Luis

AU - Angst, Denise

AU - Cabana, Michael

AU - Saiman, Lisa

AU - Kaslovsky, Robert A.

AU - Schroeder, Scott A.

AU - Padman, Raj

AU - Szymanski, Amy

AU - McNamara, John

AU - Sachs, Mary

AU - Hicks, David A.

AU - Vargas-Shiraishi, Ofelia

AU - Scanlin, Thomas

AU - Panitch, Howard B.

AU - Jansma, Barbara T.

AU - Gershan, William M.

AU - Freeman, Mary Ellen

AU - Quittell, Lynne M.

AU - Razvi, Samiya

AU - McCoy, Karen

AU - D'Antonio, Beth

AU - Dambro, Nancy N.

AU - Garbarz, Janet

AU - Murphy, Thomas

AU - McLurkin, Barbara

AU - Jones, Kimberly

AU - Gardner, Antoinette

AU - Dove, Amanda

AU - Buckley, Kathleen

AU - Schmidt, Joel H.

AU - Lipton, Andrew J.

AU - Leupold, Monica

AU - Wojtczak, Henry A.

AU - Gray, Jerri

AU - Varlotta, Laurie

AU - Conklin, Deborah

AU - Rosenbluth, Daniel B.

AU - Quante, Jane

AU - Anbar, Ran D.

AU - Lindner, Donna

AU - Lahiri, Thomas

AU - Swartz, Jackie

AU - Anderson, Paula J.

AU - Gann, Larry

AU - Hilman, Bettina

AU - Amaro, Rodolfo

AU - Rucker, Monya

AU - Davis, Scott H.

AU - Reboul, Joanna

AU - Wagner, Mary H.

AU - Spencer, Terry

AU - Capen, Cindy

AU - Kier, Catherine

AU - Carney, Teresa

AU - Rock, Michael J.

AU - Moodie, Cynthia

AU - Kissner, Dana G.

AU - LeFlore, Yvette

PY - 2008/9/1

Y1 - 2008/9/1

N2 - Background: In 2003, the American Cystic Fibrosis (CF) Foundation published revised, evidence-based guidelines for infection control. We sought to assess potential barriers to adherence to these guidelines experienced by health care professionals (HCPs) caring for CF patients. Methods: From April 2004 to December 2005, a knowledge, attitude, and practice survey was administered to HCPs at randomly selected CF centers in the United States to explore potential barriers to adherence to selected guidelines; (1) obtaining quarterly cultures from CF patients, (2) discouraging socialization among CF patients during hospitalization, (3) educating patients and families about hand hygiene, (4) educating patients and families to clean and disinfect home nebulizers, and (5) cleaning the clinic exam rooms between CF patients. Results: The survey was completed by 528 HCPs from 25 sites (5-50 respondents per site). Only 60% of respondents were aware of the guidelines, but despite awareness, 31-47% were unfamiliar with the specific guidelines. Self-reported adherence was low; only 23-63% of respondents reported practicing the selected guidelines >75% of the time/opportunities. Lack of self-efficacy, that is, confidence in adequately performing the guidelines, was commonly experienced by respondents. Access to a copy of the guidelines was associated with increased agreement with the recommendations and increased self-efficacy. Conclusions: Strategies to reduce barriers to adherence to CF infection control guidelines are needed. Strategies could include quality improvement initiatives with enhanced education and skills workshops, sharing successful interventions among CF centers, and linking adherence to improved patient outcomes.

AB - Background: In 2003, the American Cystic Fibrosis (CF) Foundation published revised, evidence-based guidelines for infection control. We sought to assess potential barriers to adherence to these guidelines experienced by health care professionals (HCPs) caring for CF patients. Methods: From April 2004 to December 2005, a knowledge, attitude, and practice survey was administered to HCPs at randomly selected CF centers in the United States to explore potential barriers to adherence to selected guidelines; (1) obtaining quarterly cultures from CF patients, (2) discouraging socialization among CF patients during hospitalization, (3) educating patients and families about hand hygiene, (4) educating patients and families to clean and disinfect home nebulizers, and (5) cleaning the clinic exam rooms between CF patients. Results: The survey was completed by 528 HCPs from 25 sites (5-50 respondents per site). Only 60% of respondents were aware of the guidelines, but despite awareness, 31-47% were unfamiliar with the specific guidelines. Self-reported adherence was low; only 23-63% of respondents reported practicing the selected guidelines >75% of the time/opportunities. Lack of self-efficacy, that is, confidence in adequately performing the guidelines, was commonly experienced by respondents. Access to a copy of the guidelines was associated with increased agreement with the recommendations and increased self-efficacy. Conclusions: Strategies to reduce barriers to adherence to CF infection control guidelines are needed. Strategies could include quality improvement initiatives with enhanced education and skills workshops, sharing successful interventions among CF centers, and linking adherence to improved patient outcomes.

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U2 - https://doi.org/10.1002/ppul.20876

DO - https://doi.org/10.1002/ppul.20876

M3 - Review article

C2 - 18671274

VL - 43

SP - 900

EP - 907

JO - Pediatric Pulmonology

JF - Pediatric Pulmonology

SN - 8755-6863

IS - 9

ER -

Garber E, Desai M, Zhou J, Alba L, Angst D, Cabana M et al. Barriers to adherence to cystic fibrosis infection control guidelines. Pediatric Pulmonology. 2008 Sep 1;43(9):900-907. https://doi.org/10.1002/ppul.20876