The purposes of the study were to examine the practice of MERS isolation guideline among hospital nurses, and to explore influencing factors of MERS isolation guideline practice as the basis for nursing intervention and protocol development for patients with MERS. A correlational survey was conducted in four hospitals of C, D cities in South Korea. A total of 182 nurses were selected to participate in this study from January 20 to February 28 in 2016. The collected data were analyzed by a statistical package SPSSWIN 22, with descriptive statistics, Pearson correlation coefficients, and hierarchical multiple regression analysis.
The major findings of the study were as follows :
1) The mean scores of MERS knowledge was 15.37 (maximum scores = 23). The items with highest scores was "goggles or face shields is required to prevent any exposure of infectious agents" and "protective clothing, disposable gloves, N95 masks, goggles or face shields must be worn to provide direct care of patients with MERS (98.9%)". However, the item with lowest score was "MERS incubation period is 2 to 15 days (4.9%)", followed by the item of "The compartment must remain empty for more than an hour after cleaning and disinfecting from the use of the patients with MERS (12.6%)".
2) The mean scores of droplet precautions knowledge was 3.68 (maximum score = 6). The item with highest score was "Sneezing, cough, sputum comes off as such, contains a pathogen in infected saliva is absorbed as it(96.2%)". The item with lowest score was "The situation is that patients wear a surgical mask, must wear a mask if the person transferring(19.2%)".
3) The average score of MERS isolation guideline practice was 3.34 points out of maximum of 4 points. The item of "medical waste treatment (3.60)" was the most complying practice among nurses, followed by "MERS handwashing (3.46)", "sampling (3.37)", "aerosol generating procedures (3.33)", "wear and removal personal protective equipment (3.33)", "Isolation room cleaning(3.12)" in orders. The participants'' MERS-CoV practice was significantly associated with their clinical experience (F=2.922, p=.023), working at infection control unit (F=13.533, p<.001), having infection management education (F=5.238, p=0.023), experience of providing direct care to patients with MERS (F=10.982, p=.001), MERS knowledge (r=.232, p=.002) and droplet precautions knowledge (r=.243, p=.001).
4) Clinical experience and Experience of providing direct care to patients with MERS explained 15.3% of variance in MERS guideline practice. When MERS knowledge and droplet isolation instructions caution knowledge were entered into the model, additional 4% variance of guideline practice was explained. Working at infection control unit(β=-.212, p=.009), clinical experience(β=.261, p<.001), droplet precautions knowledge(β=.170, p=.019) were the significant predictors of MERS-CoV isolation guideline practice.
In conclusion, hospital nurses were well aware of MERS symptoms, but only few knew incubation period, and environmental cleaning regulation. The content on droplet knowledge should also be included in education sessions for MERS control, including droplet precautions and MERS, basic contents such as definition, characteristics and isolation. Centers for Disease Control guidelines on MERS isolation needs to be constantly updated. Hospital nurses practiced most frequently for hand washing, wearing personal protective equipments, and waste disposal. However, items related to environmental infection precaution and quarantine guidelines were least performed, and need to be improved though education through systematic training methods and simulation training.