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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*
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: [email protected]

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
Copyright
© 2019 by The Society for Healthcare Epidemiology of America. All rights reserved. 

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