Influencing infection control practice: assessing the impact of a supportive intervention for nurses

Prieto, Jacqueline Anne (2003) Influencing infection control practice: assessing the impact of a supportive intervention for nurses. University of Southampton, School of Nursing and Midwifery, Doctoral Thesis , 283pp.


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The aim of this research was to examine nurses' and health care assistants' perspectives of
infection control practice on one hospital ward and use this as the basis for the development,
implementation and evaluation of an education and support programme for improving
practice on the ward.
In Phase I of the study, nurses and health care assistants were interviewed using a semistructured
interview schedule to explore their views and anxieties about infection control
practice and identify their priorities for practice development. Qualitative and quantitative
analysis of these data revealed that respondents' concerns related primarily to the use of
Contact Precautions for patients with Clostridium difficile associated diarrhoea (CDAD) and
Methicillin resistant Staphylococcus aureus (MRS A). Structured observations of practice
were employed to confirm the prevalence of the issues raised in relation to this and provide
an understanding of their context. The findings of Phase I informed the design of an
intervention to improve practice. This involved the development of a practice guideline on
Contact Precautions and the availability of practical instruction and support during its
In Phase II of the study, participant observations of practice were conducted to gain an
understanding of nurses' and health care assistants' behaviour and in particular, their
responses to the supportive intervention. Their perceptions of its impact on their practice
were ascertained in Phase III using semi-structured interviews. Qualitative analysis of these
data revealed that participants experienced great difficulty understanding and implementing
infection control recommendations. Factors that may help explain this include nurses' and
health care assistants' knowledge and skills in infection control, their personal belief systems
and self-preservation instincts. In addition, the recommendation to use Contact Precautions
for patients with infectious conditions such as CDAD and MRS A may itself counteract
attempts to promote the routine use of infection control precautions in clinical practice.
It is suggested that in relation to infection control, there may be a need to radically re-think
the ways in which health care workers are educated and supported in practice. Moreover, it is
argued that until the ambivalent evidence base relating to the use of Contact Precautions is
resolved, messages about infection control are likely to generate confusion amongst health
care workers.

Item Type: Thesis (Doctoral)
Subjects: R Medicine > RT Nursing
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions : University Structure - Pre August 2011 > Superseded (SONM)
ePrint ID: 50609
Accepted Date and Publication Date:
September 2003Made publicly available
Date Deposited: 27 Mar 2008
Last Modified: 31 Mar 2016 12:28

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