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Adoption of infection prevention and control practices by healthcare workers in Québec: A qualitative study

Published online by Cambridge University Press:  18 October 2019

Eve Dubé Open the ORCID record for Eve Dubé [Opens in a new window] ,
Armelle Lorcy ,
Nathalie Audy ,
Nadia Desmarais ,
Patrice Savard ,
Chantal Soucy ,
Samuel Bassetto ,
Mathilde Rajon ,
Fabrice Brunet  and
Caroline Barbir
...Show all authors
Eve Dubé*
Affiliation:
Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec, Québec, Québec, Canada Axe Maladies Infectieuses et Immunitaires, Centre de recherche du CHU de Québec – Université Laval, Québec, Québec, Canada
Armelle Lorcy
Affiliation:
Axe Maladies Infectieuses et Immunitaires, Centre de recherche du CHU de Québec – Université Laval, Québec, Québec, Canada
Nathalie Audy
Affiliation:
Infection Prevention and Control Division, CHU Sainte-Justine, Montréal, Québec, Canada
Nadia Desmarais
Affiliation:
Infection Prevention and Control Division, CHU Sainte-Justine, Montréal, Québec, Canada
Patrice Savard
Affiliation:
Department of Microbiology, Infectious Diseases and Immunology, Université de Montréal, Montréal, Québec, Canada Infection Prevention and Control Service, DAMU, CHUM, Montréal, Québec, Canada
Chantal Soucy
Affiliation:
Infection Prevention and Control Service, DAMU, CHUM, Montréal, Québec, Canada
Samuel Bassetto
Affiliation:
Department of Mathematics and Industrial Engineering, Polytechnique Montréal, Québec, Canada
Mathilde Rajon
Affiliation:
Department of Mathematics and Industrial Engineering, Polytechnique Montréal, Québec, Canada Université de Lyon, École Centrale de Lyon, F-69130, ECULLY, France
Fabrice Brunet
Affiliation:
Infection Prevention and Control Service, DAMU, CHUM, Montréal, Québec, Canada
Caroline Barbir
Affiliation:
Infection Prevention and Control Division, CHU Sainte-Justine, Montréal, Québec, Canada
Caroline Quach
Affiliation:
Infection Prevention and Control Division, CHU Sainte-Justine, Montréal, Québec, Canada Department of Microbiology, Infectious Diseases and Immunology, Université de Montréal, Montréal, Québec, Canada
*
Author for correspondence: Eve Dubé, Email: eve.dube@inspq.qc.ca
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Abstract

Objective:

To describe barriers and facilitators to the adoption of recommended infection prevention and control (IPC) practices among healthcare workers (HCWs).

Methods:

A qualitative research design was used. Individual semistructured interviews with HCWs and observations of clinical practices were conducted from February to May 2018 in 8 care units of 2 large tertiary-care hospitals in Montreal (Québec, Canada).

Results:

We interviewed 13 managers, 4 nurses, 2 physicians, 3 housekeepers, and 2 medical laboratory technologists. We conducted 7 observations by following IPC nurses (n = 3), nurses (n = 2), or patient attendants (n = 2) in their work routines. Barriers to IPC adoption were related to the context of care, workplace environment issues, and communication issues. The main facilitator of the IPC adoption by HCWs was the “development of an IPC culture or safety culture.” The “IPC culture” relied upon leadership support by managers committed to IPC, shared belief in the importance of IPC measures to limit healthcare-associated infections (HAIs), collaboration and good communication among staff, as well as proactivity and ownership of IPC measures (ie, development of local solutions to reduce HAIs and “working together” toward common goals).

Conclusions:

Adoption of recommended IPC measures by HCWs is strongly influenced by the “IPC culture.” The IPC culture was not uniform within hospital and differences in IPC culture were identified between care units.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 40 , Issue 12 , December 2019 , pp. 1361 - 1366
Copyright
© 2019 by The Society for Healthcare Epidemiology of America. All rights reserved. 

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References

World Health Organization (WHO), , Ducel, G, Fabry, J, Nicolle, L. Prevention of Hospital-Acquired Infections—A Practical Guide. 2nd ed. Geneva: World Health Organization; 2002.Google Scholar
World Health Organization (WHO). Antimicrobial resistance: global report on surveillance. 2014.Google Scholar
Maciosek, MV, Coffield, AB, Edwards, NM, Flottemesch, TJ, Goodman, MJ, Solberg, LI. Priorities among effective clinical preventive services: results of a systematic review and analysis. Am J Prevent Med 2006;31:52–61.CrossRefGoogle ScholarPubMed
Standard precautions in health care. World Health Organization website. http://www.who.int/csr/resources/publications/EPR_AM2_E7.pdf?ua=1. Published 2007. Accessed September 9, 2019.Google Scholar
Health and Safety Commission. Third Report: Organizing for Safety, ACSNI Study Group on Human Factors. London: HMSO; 1993.Google Scholar
Quinn Patton, M. Qualitative Research and Evaluation Methods. 4th ed. Thousand Oaks, CA: Sage; 2014.Google Scholar
Halligan, M, Zecevic, A. Safety culture in healthcare: a review of concepts, dimensions, measures and progress. BMJ Qual Safety 2011;20:338–343.CrossRefGoogle ScholarPubMed
Reed, J. Appreciative Inquiry: Research for Change. Thousand Oaks, CA: Sage; 2007.CrossRefGoogle Scholar
Reed, J, Turner, J. Appreciating change in cancer services—an evaluation’of service development strategies. J Health Organ Manag 2005;19:163–176.CrossRefGoogle ScholarPubMed
Kavanagh, T, Stevens, B, Kennedy, C. Process evaluation of appreciative inquiry to translate pain management evidence into pediatric nursing practice. Implement Sci 2010;5:90.CrossRefGoogle ScholarPubMed
Watkins, S, Dewar, B, Kennedy, C. Appreciative inquiry as an intervention to change nursing practice in in-patient settings: an integrative review. Int J Nurs Stud 2016;60:179–190.CrossRefGoogle Scholar
Yoon, MN, Lowe, M, Budgell, M, Steele, CM. An exploratory investigation using appreciative inquiry to promote nursing oral care. Geriatr Nurs 2011;32:326–340.CrossRefGoogle ScholarPubMed
Richards, L. Handling Qualitative Data: A Practical Guide. 2nd ed. Los Angeles: Sage; 2010.Google Scholar
Strauss, AL, Corbin, J. Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. Thousand Oaks, CA: Sage; 1998.Google Scholar
Buick, S, Joffe, AM, Taylor, G, Conly, J. A consensus development conference model for establishing health policy for surveillance and screening of antimicrobial-resistant organisms. Clin Infect Dis 2015;60:1095–1101.Google ScholarPubMed
Bernard, L, Bernard, A, Biron, A, Lavoie-Tremblay, M. Exploring Canadians’ and Europeans’ healthcare professionals’ perception of biological risks, patient safety, and professionals’ safety practices. Health Care Manag 2017;36:129–139.Google ScholarPubMed
Hessels, AJ, Genovese-Schek, V, Agarwal, M, Wurmser, T, Larson, EL. Relationship between patient safety climate and adherence to standard precautions. Am J Infect Control 2016;44:1128–1132.CrossRefGoogle ScholarPubMed
Dixon-Woods, M, Leslie, M, Bion, J, Tarrant, C. What counts? An ethnographic study of infection data reported to a patient safety program. Milbank Qtrly 2012;90:548–591.CrossRefGoogle ScholarPubMed
Singer, S, Lin, S, Falwell, A, Gaba, D, Baker, L. Relationship of safety climate and safety performance in hospitals. Health Serv Res 2009;44:399–421.CrossRefGoogle ScholarPubMed
Blegen, MA, Sehgal, NL, Alldredge, BK, Gearhart, S, Auerbach, AA, Wachter, RM. Improving safety culture on adult medical units through multidisciplinary teamwork and communication interventions: the TOPS Project. Qual Safety Health Care 2010;19:346–350.CrossRefGoogle ScholarPubMed
Bernard, L, Biron, A, Lavigne, G, et al. An exploratory study of safety culture, biological risk management and hand hygiene of healthcare professionals. J Adv Nursing 2018;74:827–837.CrossRefGoogle ScholarPubMed
Antimicrobial resistance—tailored antimicrobial resistance programmes to support behavioural change in the region. World Health Organization website. http://www.emro.who.int/health-topics/drug-resistance/tailored-antimicrobial-resistance-programmes-to-support-behavioural-change-in-the-region.html. Published 2018. Accessed September 9, 2019.Google Scholar
Malterud, K. Qualitative research: standards, challenges, and guidelines. Lancet 2001;358:483–488.CrossRefGoogle ScholarPubMed