Nurse survey of infection prevention and control practice in Irish public and private general hospitals in the context of the COVID-19 pandemic
Egan, Elizabeth
(2023)
Nurse survey of infection prevention and control practice in Irish public and private general hospitals in the context of the COVID-19 pandemic.
Master of Science thesis, Dublin City University.
Background:
Some healthcare-acquired infections (HAIs) can be associated with missed nursing care (MNC) and may result in adverse outcomes for patients. IPC activities are important in reducing HAIs and while MNC is a well-researched phenomenon, data on missed nursing care infection prevention and control (MNCIPC) as a specific component of MNC
is limited. COVID-19 brought the role of IPC into sharp focus as IPC practices continue to play a critical role in combating the disease.
Aim: The purpose of the study is to understand the factors that influence missed IPC practices in hospitals, including nurse compliance and non-compliance with IPC guidelines.
Methods: The study employed a quantitative cross-sectional online survey using the Practice Environment Scale of the Nursing Work Index, the World Health Organisation COVID-19 Healthcare Worker and the MNCIPC tool, which was developed to explore the failure to perform IPC activities through the lens of MNC. Data were analysed using SPSS Statistics Version 27.
Findings: There were 113 registered nurse responses. COVID-19 IPC procedures added strain to nurse workload with staff nurses showing significant differences on ‘risk to families of COVID-19 infection’, and ‘lack of control over IPC activities’ compared to other nurses. ‘Hand hygiene’ and ‘minimising hospital acquired infections’ were most frequently missed. Factors that hindered best practice occurred at systemic (staffing/resources) and environmental level (patient room overcrowding/bathroom sharing). At unit level, EDs showed significantly greater dissatisfaction with ‘IPC Resource Support’. ICU/Critical Care reported significantly greater dissatisfaction with ‘Staffing/Resource Adequacy Subscale’.
Conclusion and implications: Best practice IPC care is hampered by factors outside nurse control. Unit-specific IPC training, including support staff recommended because infection risk is associated with unit characteristics.