title: Perceptions of methicillin-resistant Staphylococcus aureus and hand hygiene provider training and patient education: results of a mixed method study of health care providers in Department of Veterans Affairs spinal cord injury and disorder units.
abstract: BACKGROUND
  The goal of this study was to assess current practices for training of spinal cord injury and disorder (SCI/D) health care workers and education of veterans with SCI/D in Department of Veterans Affairs (VA) spinal cord injury (SCI) centers on methicillin-resistant Staphylococcus aureus (MRSA) prevention.
  
  
  METHODS
  Mixed methods. A Web-based survey was distributed to 673 VA SCI/D providers across 24 SCI centers; 21 acute care and 1 long-term care facility participated. There were 295 that responded, 228 had complete data and were included in this analysis. Semistructured interviews were conducted with 30 SCI/D providers across 9 SCI centers.
  
  
  RESULTS
  Nurses, physicians, and therapists represent most respondents (92.1%, n = 210); over half (56.6%, n = 129) were nurses. Of providers, 75.9% (n = 173) reported receiving excellent or good training on how to educate patients about MRSA. However, nurses were more likely to report having excellent or good training for how to educate patients about MRSA (P = .005). Despite this, only 63.6% (n = 82) of nurses perceived the education they provide patients on how MRSA is transmitted as excellent or good.
  
  
  CONCLUSIONS
  Despite health care workers reporting receiving excellent or good training on MRSA-related topics, this did not translate to excellent or good education for patients, suggesting that health care workers need additional training for educating patients. Population-specific MRSA prevention educational materials may also assist providers in educating patients about MRSA prevention for individuals with SCI/D.
authors.affiliation: Spinal Cord Injury Quality Enhancement Research Initiative, Department of Veterans Affairs, Veterans Health Administration, Edward Hines Jr. Veterans Affairs Hospital, Hines, IL; Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, IL. Electronic address: jennifer.hill3@va.gov.
authors.forename: Jennifer N
authors.initials: JN
authors.lastname: Hill
authors.affiliation: Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, U.S. Department of Veterans Affairs, Bedford, MA; eHealth Quality Enhancement Research Initiative, National eHealth Quality Enhancement Research Initiative Coordinating Center, Edith Nourse Rogers Memorial Veterans Hospital, U.S. Department of Veterans Affairs, Bedford, MA; Division of Health Informatics and Implementation Science, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA.
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Hogan
authors.affiliation: Division of General Internal Medicine and Geriatrics, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL; Department of Preventive Medicine and Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Kenzie A
authors.initials: KA
authors.lastname: Cameron
authors.affiliation: Spinal Cord Injury Quality Enhancement Research Initiative, Department of Veterans Affairs, Veterans Health Administration, Edward Hines Jr. Veterans Affairs Hospital, Hines, IL; Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, IL; Division of General Internal Medicine and Geriatrics, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.
authors.forename: Marylou
authors.initials: M
authors.lastname: Guihan
authors.affiliation: Patient Care Services, Spinal Cord Injury/Disorders Services, Department of Veterans Affairs, Seattle, WA; Department of Rehabilitation Medicine, University of Washington, Seattle, WA.
authors.forename: Barry
authors.initials: B
authors.lastname: Goldstein
authors.affiliation: Veterans Health Administration Methicillin-resistant Staphylococcus aureus/Multi-drug Resistant Organism Program Office, National Infectious Diseases Service, Patient Care Services, Department of Veterans Affairs Central Office and the Lexington VA Medical Center, Lexington, KY; Division of Infectious Diseases, Department of Internal Medicine, University of Kentucky School of Medicine, Lexington, KY.
authors.forename: Martin E
authors.initials: ME
authors.lastname: Evans
authors.affiliation: Spinal Cord Injury Quality Enhancement Research Initiative, Department of Veterans Affairs, Veterans Health Administration, Edward Hines Jr. Veterans Affairs Hospital, Hines, IL; Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, IL; Department of Preventive Medicine and Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Charlesnika T
authors.initials: CT
authors.lastname: Evans
mesh_terms: D001521:Behavior Therapy / Q000379:methods*; D003430:Cross-Sectional Studies; D063373:Hand Hygiene / Q000379:methods*; D006787:Hospitals, Veterans; D006801:Humans; D017053:Infection Control / Q000379:methods; D007407:Interviews as Topic; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D010353:Patient Education as Topic; D011361:Professional Competence; D013119:Spinal Cord Injuries / Q000601:surgery; D013203:Staphylococcal Infections / Q000382:microbiology / Q000517:prevention & control*; D013530:Surgical Wound Infection / Q000382:microbiology / Q000517:prevention & control*
keywords: Methicillin-resistant Staphylococcus aureus; Patient education; Provider training; Spinal cord injury and disorders