Background
Health care–associated infections (HAIs) are largely preventable, but are associated
with considerable health care burden. Given the significant cost of HAIs, many health
care institutions have implemented bundled interventions to reduce HAIs. These complex
behavioral interventions require considerable effort; however, individual behaviors
and motivations crucial to successful and sustained implementation have not been adequately
assessed. We evaluated health care worker motivations to reduce HAIs.
Methods
This was a phenomenologic qualitative study of health care workers in different roles
within a university hospital, recruited via a snowball strategy. Using constructs
from the Consolidated Framework for Implementation Research model, face-to-face semi-structured
interviews were used to explore perceptions of health care worker motivation to follow
protocols on HAI prevention.
Results
Across all types of health care workers interviewed, patient safety and improvement
in clinical outcomes were the major motivators to reducing HAIs. Other important motivators
included collaborative environment that valued individual input, transparency and
feedback at both organizational and individual levels, leadership involvement, and
refresher trainings and workshops. We did not find policy, regulatory considerations,
or financial penalties to be important motivators.
Conclusions
Health care workers perceived patient safety and clinical outcomes as the primary
motivators to reduce HAI. Leadership engagement and data-driven interventions with
frequent performance feedback were also identified as important facilitators of HAI
prevention.
Key Words
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References
- Multistate point-prevalence survey of health care-associated infections.N Engl J Med. 2014; 370: 1198-1208
- Healthcare-associated infections (HAIs), data and statistics page.(Available from:)https://www.cdc.gov/hai/surveillance/(Accessed November 8, 2016)Date: 2016
- Overview: Hospital-Acquired Condition (HAC) Reduction Program.(Available from:) (Accessed November 8, 2016)
- Hospital-Acquired Condition Reduction Program (HACRP).(Available from:) (Accessed November 8, 2016)
- Closing the quality gap: revisiting the state of the science (vol. 6: prevention of healthcare-associated infections).Evid Rep Technol Assess (Full Rep). 2012; 208: 1-578
- The direct medical costs of healthcare-associated infections in U.S. hospitals and the benefits of prevention.(Publication No. CS200891; Available from:) (Accessed July 7. 2017)
- HAC-POA policy effects on hospitals, other payers, and patients.Medicare Medicaid Res Rev. 2014; 4
- Chief nursing officers' perspectives on Medicare's hospital-acquired conditions non-payment policy: implications for policy design and implementation.Implement Sci. 2012; 7: 78
- The Lowbury lecture: behaviour in infection control.J Hosp Infect. 2004; 58: 1-13
- Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science.Implement Sci. 2009; 4: 50
- The Seattle virus watch. V. Epidemiologic observations of rhinovirus infections, 1965-1969, in families with young children.Am J Epidemiol. 1975; 101: 122-143
- Towards changing healthcare workers' behaviour: a qualitative study exploring non-compliance through appraisals of infection prevention and control practices.J Hosp Infect. 2015; 90: 126-134
- Staff compliance with infection control practices: application of behavioural sciences.J Hosp Infect. 1995; 30: 107-115
- A survey of doctors' and nurses' knowledge, attitudes and compliance with infection control guidelines in Birmingham teaching hospitals.J Hosp Infect. 2003; 54: 68-73
- The importance of leadership in preventing healthcare-associated infection: results of a multisite qualitative study.Infect Control Hosp Epidemiol. 2010; 31: 901-907
- P168: Leadership styles of ward head nurses and implementation success–a qualitative inquiry in the framework of a mixed-method study on hand hygiene promotion through patient involvement.Antimicrob Resist Infect Control. 2013; 2: 168
- Developing leadership capacity for guideline use: a pilot cluster randomized control trial.Worldviews Evid Based Nurs. 2013; 10: 51-65
- Leadership and organizational change for implementation (LOCI): a randomized mixed method pilot study of a leadership and organization development intervention for evidence-based practice implementation.Implement Sci. 2015; 10: 11
Article info
Publication history
Published online: July 25, 2017
Footnotes
Funding/support: N.S. is supported by a Veterans Affairs-funded patient safety center and an R18 from the Agency for Healthcare Research and Quality (R18HS024039 to R18).
Conflicts of interest: None to report.
Identification
Copyright
Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc.
