NL
Healthcare providers often experience moral tensions when caring for patients with resistant bacteria, also known as carriers of a Highly Resistant Microorganism (HRMO). They want to prevent the spread of the bacteria to others, but at the same time ensure the well-being of the patient. They also struggle with justifying extra care time for carriers, which is at the expense of other patients. In addition, they are concerned about their own safety and health. Furthermore, tension arises from the need to provide care while the use of personal protective equipment (PPE) places a burden on the environment.
These moral tensions were identified in a qualitative study among healthcare providers in hospitals and nursing homes. The study shows that healthcare providers who treat BRMO carriers are confronted with various moral dimensions in healthcare that arise from infection prevention measures such as isolation and the use of PPE, which are intended to prevent the transmission of BRMOs to others.
Four key moral tensions were identified in interviews with 29 healthcare providers:
- Tension between transmission prevention and patient well-being
Healthcare providers experience tension between preventing the spread of BRMO and ensuring patient well-being. They notice that wearing protective equipment makes them less recognizable to patients, which gives them the impression that they cannot always provide the right care. - Justifying extra time for carriers
Healthcare providers struggle to justify the extra time they spend on BRMO carriers due to PPE use, which is at the expense of caring for other patients. This tension arises mainly in the context of limited time and staff shortages. - Concerns about personal safety and health
Many healthcare providers are concerned about their own safety and health when caring for patients with resistant bacteria. They often feel uncertain about the level of protection offered by personal protective equipment. - Tension between healthcare provision and environmental impact
Healthcare providers also feel the tension between the need to provide care and the environmental impact of using PPE. Some healthcare providers experience feelings of guilt when they feel they are using protective equipment unnecessarily, such as when simply pressing an alarm button, thereby unnecessarily impacting the environment.
The study emphasizes that both healthcare providers and their organizations should recognize these moral tensions and actively address them. This can contribute to the professional well-being of healthcare providers and improve care for patients with BRMO.