Surgical site infections after craniotomy: a matched health-care cost and length of stay study.

OBJECTIVE: To assess the extra health-care costs and length of stay resulting from surgical site infection (SSI), as well as to identify the most frequent aetiological microorganisms of SSIs among Jordanian craniotomy surgery patients. METHOD: A retrospective, descriptive, correlational and nested 1:1 matched case-control design was used. A computerised list of patients, who underwent surgery between May 2009 and March 2015, was generated in the targeted hospital. A final bill for every selected patient was also determined. Patients were divided equally into two groups: patients with an SSI and patients without an SSI. RESULTS: A total of 64 patients were recruited. The SSI-group had a significant higher mean health-care cost of $7,899.08 (p=0.001) and a longer stay in hospital (mean additional days: 23.17) than the non-SSI group. Furthermore, Acinetobacter baumannii and Staphylococcus aureus were determined as the most predominant causative agents of SSI, at 39.1% and 26.1% of SSI patients, respectively. CONCLUSION: The results of this study can be considered as a baseline for national benchmarking to evaluate the quality of care provided to targeted patients. This study should encourage nurse administrators to adopt protocols and strategies that promote infection control measures, as well as to develop new methods of surveillance on universal precautions adherence. This may limit pathogen contamination in the surgical wound, shorten length of stay and decrease health-care costs.

Research Use of Nurses Working in the Critical Care Units: Barriers and Facilitators.

BACKGROUND: There is a distinct gap between theory and practice with respect to research use in clinical practice, particularly in critical care units, that could be related to the presence of a number of barriers that hinder the use of research findings. AIMS: The aims of the study were to identify barriers and facilitators to research use as perceived by Jordanian nurses in critical care units and to examine the predictors of research use among those nurses. METHODS: The study used a cross-sectional, correlational design. The self-administered "Barriers Scale" was introduced to 200 registered critical care nurses, using the drop-and-collect technique, between October and November 2015. RESULTS: The results revealed that "nurse does not have time to read research at work" was the top ranked barrier that hinders research use (mean [SD], 3.45 [0.79]). The first 7 ranked barriers were related to the organizational subscale. Managerial support was the top perceived facilitator for research use. Only "attending special training courses in nursing research" was the significant predictor of research use and explained 59.1% of the variance in research use, t(190) = -3.93, P = .003. The most identified barriers toward research use revealed by the qualitative data include dominant routine nursing tasks, existence of gap between theory and practice, shortage of nursing staff, and public negative image about nursing profession. Participants suggested the importance of increasing organizational support and creating an organizational research culture to further promote research use in clinical nursing practice. CONCLUSIONS: Research use has not been widely implemented yet in Jordan because of various barriers. The organization-related barriers were the most influential. Factors hindering research use are multidimensional, and optimizing them should be a shared responsibility of nurse managers, researchers, clinicians, and academicians. Further initiatives are required to raise awareness of the importance of using evidence-based practice.

The effects of health beliefs on health care-seeking decisions of Jordanian patients with myocardial infarction symptoms.

The main purpose of this study was to examine the significance of health beliefs, perceived seriousness of harmful consequences and perceived barriers in explaining health care-seeking decisions of patients experiencing myocardial infarction symptoms. A structured interview guide developed by the researchers that included health beliefs, patient delay, sociodemographics and clinical characteristics of the patients was introduced to 79 myocardial infarction patients on the third day of hospitalization. Thirty-eight per cent of the patients delayed the health care-seeking decision > 1 h. Gender, age and perceived seriousness of the consequences significantly distinguished between delayers and non-delayers, correctly classifying 77% of the cases. Delayers were more likely to be female and young adults, and those who perceived increased negative consequences to myocardial infarction. Educational and counselling programmes for individuals at increased risk for myocardial infarction should consider the negative influence of perceived seriousness of consequences on the decision-making process of the patients. Also, interventions to change women's perception of their vulnerability to this illness are needed.