Healthcare Workers’ Knowledge, Attitude, and Practice Towards Acquired Infections During Extracorporeal Membrane Oxygenation: An International Study Publisher



Aa Hssain Ali AIT ; F Bahramnezhad FATEMEH ; A Vahedianazimi AMIR ; Ass Ibrahim Abdulsalam Saif S ; If Hassan Ibrahim FAWZY ; Aa Imani Fooladi Abbas ALI ; A Moradi ALI ; E Azoulay ELIE ; M Darmon MICHAEL
Source: Intensive and Critical Care Nursing Published:2025

Abstract

Background: This study aimed to evaluate healthcare workers’ (HCWs) knowledge, attitudes, and practices (KAP) regarding acquired infections during ECMO and to predict KAP scores based on demographic, professional, and institutional characteristics. Method: An international cross-sectional survey was conducted using an online self-administered questionnaire continuously from August through October 2024. The questionnaire's validity and reliability were rigorously assessed, and it comprised 54 questions divided into four sections. The first section focused on the demographic, professional, and institutional characteristics of the HCWs, while the second, third, and fourth sections assessed the KAP regarding ECMO-related acquired infections, with fourteen questions in each section (a total of 42 questions), using a Likert scale ranging from 1 (strongly disagree) to 7 (strongly agree). Results: The study involved 566 HCWs from 76 countries across various ECMO-related roles. Key findings revealed significant links between KAP scores and professional role, ECMO experience, and caseload. Notably, less experienced HCWs and those managing fewer ECMO cases, particularly in specialized adult ICUs, demonstrated higher practice scores. Older age, male gender, and physician status correlated with greater knowledge and more positive attitudes. Multivariate and decision tree analyses identified professional role and ECMO experience as primary predictors of KAP. The predictive model showed strong accuracy (AUC = 0.747) and a nonlinear relationship between caseload and KAP, underscoring the importance of targeted education and standardized protocols to enhance infection control in ECMO care globally. Implications for clinical practice: Targeted training programs and standardized protocols can enhance HCWs’ knowledge and practices in preventing ECMO-related infections. Promoting continuous learning and leveraging best practices from specialized ICUs can improve patient safety. Conclusion: The survey underscores the importance of targeted training and continuous education to enhance infection management practices among ECMO teams. By addressing factors influencing KAP, healthcare systems can improve patient outcomes and reduce infection risks associated with ECMO. © 2025 Elsevier B.V., All rights reserved.