Moral tensions when providing care to MDRO carriers: A qualitative study among health care providers in Dutch hospitals and nursing homes.

BACKGROUND

To prevent the spread of multidrug-resistant organisms (MDROs), adherence to infection prevention measures is essential. However, these measures can negatively affect both patients and health care providers (HCPs), leading to various moral tensions. We aimed to investigate moral tensions in providing care to MDRO carriers as experienced by HCPs.

METHODS

We performed semistructured interviews with 29 HCPs from 2 hospitals and 3 nursing homes. Thematic analysis was with a double-coder process supported by ATLAS.ti software.

RESULTS

We identified 4 moral tensions. First, HCPs experience tension between wanting to prevent transmission and safeguarding patients' well-being. HCPs struggle with being less recognizable to patients. Second, HCPs grapple with justifying the increased time spent on carriers, which comes at the expense of other patients, within the context of scarce time. Third, HCPs experience concerns about personal safety and health while caring for others. Most HCPs are very aware of the transmission risk and feel unsure to what extent they are protected. Fourth, HCPs feel tension between the necessity to care and the environmental impact of personal protective equipment.

CONCLUSIONS

HCPs and their organizations should acknowledge and act on moral tensions to contribute to professional well-being and improvement of care for MDRO carriers.