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

Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a serious
\nnosocomial and community-associated pathogen in aboriginal people in Canada
\n(Canadian Pediatric Society, 2005). A recent survey with First Nations employed
\ncommunity health nurses (CHNs) in the Atlantic region found that nursing knowledge is
\nlowest in the area of emerging infections such as MRSA (Mi?kmaq Confederacy of
\nPrince Edward Island, 2009). The objective of this project is to review the nursing
\nliterature on this topic and to describe the factors that contribute to low nursing
\nknowledge of MRSA. A search of the literature published during 2000-2008 using
\nMedline, CINAHL with full text, DARE, and CDSR was conducted using the following
\nsearch terms: ?community-acquired MRSA?, ?hospital-associated MRSA?, ?hospital acquired
\nMRSA?, ?community-associated MRSA?, ?MRSA?, ?community health
\nnursing?, ?nurse? ?nursing?, ?antibiotic resistant organisms?, ?nosocomial infections?
\nand ?knowledge?. The search generated 48 papers for review. For each paper,
\ninformation was obtained on the study population, health care setting (acute or
\ncommunity), geographic location of the research, and the study type. Publications were
\nsorted by topic area MRSA (CA-MRSA, HA-MRSA or both) or nosocomial infections.
\nThe articles were also organized into key theme areas for further description. Sixty-two
\nand one half percent (30) of the papers referred to healthcare workers as the study
\npopulation (nurses, doctors, aides, dentists). Nurses were the primary study population in
\n37.5% (18) of the papers, with only three of these papers focused on community health
\nnurses. The research in this area has emerged from the United Kingdom (37.5%) and the
\nUnited 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
\ntwo of the papers discussing CA-MRSA, Thirty-seven and one half percent of the papers
\nfocused on the broader topic of nosocomial infections. Acute care is the most common
\nsetting for research in this area (73%). Only five articles were found on this topic in a
\ncommunity setting. The majority of literature available addresses MRSA knowledge
\ndeficits and strategies to address them. There is limited literature published on the factors
\ncontributing to low nursing knowledge of MRSA. The review suggests that a gap exists
\nin infection control content in nursing curriculum at the undergraduate level and between
\nnurses? reported knowledge and practice. The review also suggests that nurses? personal
\nway of knowing contributes to their knowledge ofMRSA. Further research is required
\non these factors. Additional research on this topic is needed in Canada and in a variety of
\nnursing practice settings. Nurses employed in First Nations communities warrant
\nincreased attention considering the implications of MRSA in aboriginal people.

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