5/28/19

Ana Clemmer

Independent Research I

Grade 10

Research Title: ​When Germs Fight Back, What Do We Do?

Overview of Research

I am researching antimicrobial resistance. Mainly, I am focusing on the knowledge,

attitudes, and practices of healthcare professionals in the United States regarding

antimicrobial resistance. This includes prescription, general cleanliness, and

handwashing. Additionally, my research has grown to cover the general public as well,

Background​ ​(annotations, stasis)

Though antimicrobial resistance has been known for decades, it is still a rapidly emerging

problem. Antimicrobial resistance (AMR) was identified within 20 years after the

development of antimicrobial drugs (Ventola, 2015a). Yet AMR is a growing problem

worldwide in hospital-acquired infection (Labricciosa, 2018). AMR increases mortality,

medical costs, and length of hospital stays (World Health Organization [WHO], 2018).

Over 23,000 people die annually as a direct result of antibiotic resistant infections, which

is one kind of AMR (“The End of Antibiotics?” 2018).

Antimicrobial resistance develops through the effect of the antimicrobial medicine being

neutralized, and thus the microbes avoid the lethal effect of the antimicrobial drug. The

exposure to antibiotics can create selective pressure, killing susceptible bacteria and

allowing antibiotic resistant bacteria to survive and multiply. Also, bacteria can mutate
 and transfer antimicrobial resistance genes, contributing to the antimicrobial resistance

gene pool (“Antibiotic resistance: questions and answers” n.d.).

Problem Statement​ ​(thesis board)

There is an obvious disconnect between the extensive knowledge of healthcare

professionals and the practices performed. Practices concerning antimicrobial resistance

do not match knowledge, leading to an increase in antimicrobial resistance. This includes

incorrect prescription, lack of adequate cleanliness, and improper hand hygiene. Action is

being taken to increase education in antimicrobial resistance, but the follow through with

practice is lacking.

Research Methodology

Research Questions and Hypothesis​ ​(stasis)

Do practices of healthcare professional concerning antimicrobial resistance match

knowledge? Healthcare professionals are knowledgeable about antimicrobial

resistance, but they do not practice appropriate practices concerning antimicrobial

resistance, indicating a gap in knowledge and practice.

How does the knowledge, attitudes, and practices of the general population of

Maryland concerning antimicrobial resistance compare to those of global

healthcare professionals? The general population of Maryland will know less than

global healthcare professionals, will not see antimicrobial resistance as being as

much of a problem, and have more risky practices to spread antimicrobial

resistance.

Basis of Hypothesis​ ​(why you think this will work- “it will show that…”)
 From my reading, I have found that it is common for medical professionals to be

quite knowledgeable about antimicrobial resistance. However, their practices do

not always match their knowledge. My research will explore this question of how

the knowledge and practices compare for medical professionals in the United

States.

From my reading, I have gathered that patients often cause healthcare

professionals to incorrectly prescribe because they demand antimicrobial

treatment. Patients may do this because they are not knowledgeable enough about

antimicrobial resistance and do not consider it a large issue. My research will

explore how the knowledge, attitudes, and practices of the general population of

Maryland concerning antimicrobial resistance compares to those of global

healthcare professionals and the general population discussed in my reading.

Research Design

I am pursuing descriptive research using two knowledge, attitudes, and practices (KAP)

surveys, allowing me to determine if there is a disconnect between knowledge and

practices concerning antimicrobial resistance among healthcare professionals and the

general public. My second KAP survey will allow me to determine how the general

population of Maryland’s knowledge, attitudes, and practices concerning antimicrobial

resistance .​ My first questionnaire is geared towards healthcare professionals, while my

shorter, simpler one is more suited for the general public. Both of these surveys are

developed based on questions from professional surveys conducted. For my project, I am

pamphlet.

Operational Definitions​ ​(outline- look through sources)

Knowledge: I will be exploring what healthcare professionals are aware of and know

about antimicrobial resistance, including top causes which will be explored through

open-ended questions.

Attitudes: How the respondents view antimicrobial resistance as a problem and a threat

Practices: How the respondents take action toward and to prevent antimicrobial resistance

Product Overview

My goal is to create an engaging presentation displaying my findings and do a brown bag

presentation at a medical center, clinic, or hospital. If this does not work out, I will create

a pamphlet or flyer and distribute it among as many healthcare professionals as I can.

Logistical Considerations

I have decided on an email survey. This has the advantage of respondents not having to

meet with the research and also saving time in obtaining survey responses, which allows

for the possibility of a greater number of participants in the survey. However, email

surveys require the medical professionals to respond to the email request, and articles

have indicated a rather small response rate for some email surveys. One method to

increase the response rate is that I will send the survey to medical professionals who I

know and ask them to send to not only answer the survey but also forward the survey to
 their colleagues. In that way, all of the requests for responses will be made by someone

who is known.

For considerations regarding the research, I created two surveys. One of them was sent

through multiple healthcare professionals, and the other to a Facebook group for my

neighborhood and to my Instagram story.

For the consideration of the product, I have various professional healthcare contacts, and

I am requesting to visit. Additionally, I will create colorful, laminated flyers to put up in

all the bathrooms of the school.

Timeline

By mid March, I will finalize my questionnaire. My questions are already developed for

the most part, however they need to be made more concise. My surveys will be

conducted through April and May. In the end of May, I will be analyzing my data and

putting it into my synthesis paper. Then, I am aiming to have a final product by the end of

June.