Exploring nurses’ internal motivations for adhering with infection prevention standard precautions in a tertiary teaching hospital

Natalie A Parkes

The use of Infection Prevention and Control (IPC) standard precautions is associated with reduced incidence of healthcare associated infections (HCAI); however, compliance by Health Care Workers (HCWs) is inconsistent. One in every 74 patients will develop a HCAI (ACSQHC, 2018), with the three most common HCAIs including urinary tract infections, surgical site infections and pneumonia (AIHW, 2024). Unfortunately, some of these will result in a blood stream infection which has a 20% mortality rate (AIHW, 2020), and on average an additional 20.6 days in hospital and $42,724.00 in associated costs (ACSQHC, 2018). The aim of this research was to explore the internal factors that promote or prevent behavioural compliance with IPC practices by Nurses. Having an in-depth comprehension of the internal factors can inform potential strategies to improve behavioural compliance and outcomes for patients. This study used an interpretive description methodology, making use of individual, semi structured interviews with nursing staff (n=9) from a major tertiary teaching hospital group. Thematic analysis identified four main themes impacted on nursing compliance with IPC standard precautions; ‘teamwork and belongingness’; ‘connection with education’; ‘psychological fatigue’; and ‘risk’. The findings identified the significance of the emotional connection nursing staff require with their team to buffer them against stressors which inhibit their ability to deliver care. It also identified the importance of how education is delivered to explain the rationale behind IPC practice changes. Lastly, the importance of being able to see through the lens of the patient’s experience and understand the risk they are exposed to when admitted into hospital. Based on these findings, the recommendations include strategies to strengthen the sense of belongingness at both the organisational and unit level, as well as implementing a structured model for the implementation and embedding of change to limit psychological fatigue. Recommendations for education include incorporating a framework into the curriculum on critical thinking and clinical decision making, and to design a program for all nursing education staff on how to teach IPC, with a robust coaching program extending beyond the education team.

Exploring nurses’ internal motivations for adhering with infection prevention standard precautions in a tertiary teaching hospital

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