Deficient knowledge of multidrug-resistant bacteria and preventive hygiene measures among primary healthcare personnel

J Adv Nurs. 2011 Apr;67(4):756-62. doi: 10.1111/j.1365-2648.2010.05533.x. Epub 2010 Dec 28.


Aim: This paper is a report of a study conducted to describe primary healthcare personnel's knowledge of multidrug-resistant and preventive hygiene measures.

Background: The group of patients at risk for multi-drug resistant bacteria is largely cared for in primary care. Knowledge of multidrug-resistant and hygiene preventive measures among primary healthcare personnel is therefore essential.

Method: A descriptive and comparative questionnaire survey among primary healthcare personnel was performed in 2008. In total, five urban and rural primary healthcare centres situated in one county in central Sweden were included. Convenient sampling was used and 10 physicians, 38 district nurses and 10 nursing assistants participated. Knowledge/medical facts concerning multidrug-resistant and hygiene preventive measures were investigated and data were analysed using a quantitative approach.

Results: Knowledge/medical facts concerning several aspects of multidrug-resistant bacteria, particularly Extended-Spectrum-Beta-Lactamase producing bacteria, were deficient as was knowledge of different aspects of hygiene preventive measures. Physicians showed significantly better results than district nurses and nursing assistants did. Awareness of proper hand-washing as an effective preventive method and use of aprons in nursing care was high among all participants. Staff who knew they had cared for these patients had significantly better results than the others did.

Conclusion: Our findings suggest that evidence-based education of multidrug-resistant and hygiene preventive measures, in primary health with subsequent follow-ups should become a prioritized clinician and management concern. Research is needed that focus implementation of evidence-based educations, staff attitudes and responsibilities related to the work with patients at risk of multidrug-resistant bacteria.

MeSH terms

  • Carrier State / microbiology
  • Clinical Competence / standards
  • Disease Transmission, Infectious / prevention & control*
  • Drug Resistance, Multiple, Bacterial*
  • Enterobacteriaceae / enzymology
  • Enterobacteriaceae Infections / microbiology
  • Enterobacteriaceae Infections / prevention & control
  • Female
  • Guideline Adherence
  • Hand Disinfection
  • Health Knowledge, Attitudes, Practice*
  • Health Personnel*
  • Humans
  • Hygiene*
  • Infection Control / methods
  • Male
  • Methicillin-Resistant Staphylococcus aureus
  • Middle Aged
  • Primary Health Care*
  • Protective Clothing / statistics & numerical data
  • Risk Factors
  • Staphylococcal Infections / microbiology
  • Staphylococcal Infections / prevention & control
  • Sweden
  • beta-Lactamases / metabolism


  • beta-Lactamases