HSR&D Home » Research » RRP 09-125 – QUERI Project
Development and Testing of MRSA educational materials for SCI
Charlesnika Tyon Evans, PhD MPH BS
Edward Hines Jr. VA Hospital, Hines, IL
Funding Period: June 2009 - August 2010
Methicillin-resistant Staphylococcus aureus (MRSA) is a frequent cause of infection in the U.S. and in persons with spinal cord injury or disorder (SCI/D). Materials developed for the general VA population do not address the unique challenges that face Veterans with SCI/D.
1) Identify and evaluate current VA/non-VA MRSA education documentation for patients, caregivers, and providers using input from an expert panel, patient and provider focus groups and caregiver interviews;
2) Revise and adapt existing VA MRSA education materials to address important unique SCI/D-related issues;
3) Assess the effect of educational materials on knowledge and behavior in patients via a randomized controlled trial (RCT) at two VA SCI Centers;
4) Develop a toolkit in preparation of national roll-out to all VA SCI centers.
Multiple methodologies were used at two sites including: an expert panel, focus groups with SCI/D patients and providers, input from an "educated consumer panel", and an RCT of SCI/D patients randomized to control (usual care) or intervention (new educational materials) group with a pre-test/post-test assessment of knowledge and behavior.
Six focus groups with 33 providers (76% nurses/24% physicians) and 1 patient focus group (n=8) were conducted at two sites. We found that at baseline, patient education about MRSA and hand hygiene was limited, providers identified a need for SCI/D-specific educational materials and effective ways to teach patients about MRSA. New educational materials were developed based on focus group data and expert panel input and tested with 61 patients (Intervention n=30, Control n=31). Overall, the mean knowledge score increased between the pre-test and post-test period (12.4 vs. 14.0, p=0.003), but the change in score did not significantly differ between the intervention and control groups (1.7 vs. 1.5, p=0.81). Most subjects' hand hygiene behavior either stayed the same or increased (57.4% to 86.9%). Intervention group subjects were significantly more likely to report improved hand hygiene behavior (60.0% vs. 29.0%, p=0.02) and more likely to report having asked their provider about their MRSA status (46.7% vs. 16.1%, p=0.03) compared to controls.
This study developed and tested educational materials that will be included as part of a toolkit to assist providers in providing MRSA information to patients with SCI/D and their informal caregivers in a future national implementation study.
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Keywords: Education (patient), Infectious disease, Spinal cord injury
MeSH Terms: none