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Barriers to Candida auris Prevention Among Frontline Healthcare Workers in Long-Term Acute Care Hospitals

Published online by Cambridge University Press:  24 September 2025

Sarah Sansom
Affiliation:
Rush University Medical Center
McKenzi King
Affiliation:
Rush University Medical Center
Christine Lucky
Affiliation:
Rush University Medical Center
Lisa Duffner
Affiliation:
RML Specialty Hospital
Lahari Thotapalli
Affiliation:
Rush University Medical Center
Laura Rusie
Affiliation:
Rush University Medical Center
Rachel Medernach
Affiliation:
Rush University Medical Center
Mary Carl Froilan
Affiliation:
Rush University Medical Center
Nidhi Undevia
Affiliation:
Rush University Medical Center
Mary Hayden
Affiliation:
Rush University Medical Center

Abstract

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Background: Gaps in knowledge and compliance regarding control of Candida auris contribute to ongoing spread in healthcare facilities, but few studies have evaluated barriers to effective prevention measures. Methods: We assessed the knowledge, attitudes, beliefs, and practices for control of C. auris among frontline healthcare workers at 2 long-term acute care hospitals (LTACH) with high admission prevalence of C. auris in the Chicago, Illinois region. Surveys included 92 questions including the following subjects: participant demographics; awareness of multidrug-resistant organisms [MDRO]; attitudes and beliefs regarding C. auris; motivation for using and compliance with personal protective equipment [PPE]; knowledge of C. auris prevention measures; perceived barriers and facilitators of C. auris prevention; sources of education and training; and preferred learning styles. Responses were measured on a 5-point Likert scale. Anonymous online surveys were administered during the one-month study period Recruitment efforts included posters, fliers, email, and in-person rounds with the LTACH infection preventionist. Participants were eligible to win a gift card upon survey completion. Only complete surveys were analyzed. Results: Fifty-three surveys were completed (estimated 12% response rate across all facility staff) with respondents identifying as 92% female, 43% nurses, and 60% with >10 years of experience in their current role. Participants were familiar with commonly identified MDROs (i.e., Clostridoides difficile [98%], methicillin-resistant Staphylococcus aureus [88%]) but were less aware of extended-spectrum β-lactam-resistant (68%) and carbapenem-resistant pathogens (56-79%) (Figure 1). Participants felt that their actions helped prevent C. auris spread (85%) but were less confident when asked whether C. auris is a problem at their own hospital (53%). Participants were able to successfully identify most prevention strategies for C. auris (≥72% correct for all measures). The highest ranked barriers to C. auris prevention were understaffing (63%) and inadequate training (51%) (Figure 2). Information regarding C. auris was most commonly obtained through training provided within their hospital (62%) and from coworkers (45%). Participants responded that they prefer to learn about infection prevention through in-person teaching by experts at their facility (83%) or from another institution (79%), although self-learning styles were also popular (67-73%) (Figure 3). Conclusion: We identified perceived barriers to effective C. auris prevention among frontline healthcare workers in 2 LTACHs. While staff members successfully identified most prevention strategies for C. auris, they may benefit from enhanced education and training programs that support multiple learning styles.

Information

Type
Long Term Care
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America