Accepted for/Published in: Journal of Participatory Medicine
Date Submitted: Jun 7, 2019
Date Accepted: Feb 22, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Development of a MRSA Decolonization Toolkit with Patient and Parent Advisors: A Qualitative Study
ABSTRACT
Background:
Community acquired Methicillin-Resistant Staphylococcus aureus (MRSA) skin and soft tissue infections (SSTI) affect many otherwise healthy children. A significant number of these children are hospitalized and require surgical procedures such as incision and drainage for treatment. Decolonization procedures may be recommended after hospitalization to prevent the high rate of recurrent infections.
Objective:
The objective of this component of the MRSA Eradication and Decolonization in Children (MEDiC) study was to develop a toolkit to assist MEDiC study participants with MRSA decolonization and hygiene procedures (the MEDiC Kit).
Methods:
Five adolescents (age 10-18) who had undergone an incision and drainage procedure for a skin infection and eleven parents of children who had undergone an incision and drainage procedure for a skin infection were engaged in one four-hour group workshop using a human-centered design (HCD) approach. The topics covered in this workshop and analyzed for this paper were 1) attitudes about MRSA decolonization procedures, and 2) barriers to implementation of MRSA decolonization and hygiene procedures. The team analyzed audio and artifacts created during the workshop and synthesized their findings to inform the creation of the MEDiC Kit.
Results:
The workshop activities uncovered barriers to successful completion of the decolonization and hygiene procedures: Lack of step-by-step instruction, lack of proper tools in the home, concerns about adverse events, lack of control over some aspects of the hygiene procedures, and general difficulty coordinating all of the procedures. Many of these were able to be addressed as part of the MEDiC Kit. In addition, the workshop uncovered that effective communication about decolonization would have to address concerns about the effects of bleach, provide detailed information, give reasons for the specific decolonization and hygiene protocol steps, and include step-by-step instructions (preferably through video).
Conclusions:
Through direct engagement with patients and families, we were able to better understand how to support families in implementing the MRSA decolonization and hygiene protocols. In addition, we were able to better understand how to communicate about MRSA decolonization and hygiene protocols. With this knowledge, we created a robust toolkit that uses patient-driven language and visuals to help support patients and families through implementation of these protocols. Clinical Trial: NCT02127658
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