Blackman , et al . ( 2022 ) found
13 variables which they say exert direct effects on the nurses ’ missed infection control care , including surveillance , hand hygiene practices , minimizing bacterial colonization , and use of specific precautions , all of which are known to be paramount in preventing infections .” that because of this ; personal experience may often be used as an excuse to override policy and organizational standards . Shah , et al . ( 2015 ) found that occasionally , shortcuts and workarounds were used to balance the HAI risk against other patient needs . This practice can be problematic , McCauley , et al . ( 2021 ) say , since the beliefs and practices of individual nurses can often influence the behavior of others around them : “ A nurse ’ s level and type of experience can influence their specifics attitudes and beliefs towards infection prevention and control practices and guidelines , and these , in turn , may influence their levels of compliance . In addition to the belief that personal experience can be used to override infection control guidelines , another personal factor influencing compliance is how nurses view their susceptibility to infection . Feelings that one ’ s health is strong and not at risk can reduce compliance with infection control , while fears about susceptibility to infection can lead to the opposite behavior .”
Blackman , et al . ( 2022 ) found 13 variables which they say exert direct effects on the nurses ’ missed infection control care , including surveillance , hand hygiene practices , minimizing bacterial colonization , and use of specific precautions , all of which are known to be paramount in preventing infections .
In their study , the researcher found that most of the respondents were female , aged between 40 and 59 years , employed full‐time , having more than 10 years of experience , and planning to leave their current work in the next two years or so . The majority also thought there was adequate staffing 75 percent of the time to meet infection control requirements but were split as to the number of times they had undertaken extra shifts of care over a duration of three months . Most nurses indicated that in any one shift , they may have up to six admissions and / or discharges to be completed . The majority indicated that they had not attended infection control-related staff development sessions over the past 12 .
In magnitude of importance and having the largest effect on MICC is missed care related to reducing HAIs followed closely by surveillance . Missed care associated with hand hygiene was the third strongest factor followed by specific precautions and strategies to reduce bacterial colonization , according to Blackman , et al . ( 2022 ).
The researchers found that staff retention also influences rates and types of missed nursing care , and that staff members planning to leave their current work identified more instances of overall missed infection control-related care compared with staff who wanted to remain in their current roles . They discovered that nurses who attend annual compulsory staff development witness more frequent occurrence of missed infection control care compared with staff who do not . They are more likely to identify missed care as it relates to minimizing HAI , taking specific precautions , surveillance and missed care overall .
Work intensity can affect the level of care provided , the researchers found , reporting that as admission rates increase , so do the overall frequencies of missed infection control-related care , and notably all aspects of hand hygiene . Older nurses described greater instances of missing aspects of hand hygiene and strategies to reduce bacterial contamination ( including ensuring equipment is cleaned prior to touching the patient and ensuring areas decontaminate after spills ) compared with their younger colleagues . Part‐time nursing staff reported more instances of infection control missed care overall than staff members who work full‐time , especially as related to all aspects of hand hygiene and all strategies to reduce HAIs .
As Blackman , et al . ( 2022 ) emphasize , “ Evidence from this study suggests that infection control care is missed , its origins are multifactorial and the sources for potential infection are linked . Strongly implicated in this study is propensity for the risk HAIs related to missed infection control care and hand hygiene and surveillance . Healthcare‐acquired infections can be best minimized when invasive procedures ( catheters and vascular lines ) are deferred in favor of less intrusive treatment options . Hospital hygiene is underestimated by nursing staff across all countries as a mechanism to reduce nosocomial infections secondary to bacterial colonization . The origins of reduced staff hand hygiene compliance rates require an ongoing , whole‐of‐organization approach with educational interventions for improved staff adherence . Infection control surveillance remains a key to reducing HAIs , but unless there is active and continuous scrutiny , the incidences of HAI may be underreported and untreated .”
Going Forward
McCauley , et al . ( 2021 ) point out to a lack of literature focusing on why nurses miss transmission-based precautions , which is relevant to the COVID pandemic . They observe , “ In light of the COVID-19 pandemic , it seems imperative to adjust our professional focus towards infection prevention and control practices , and particularly on the factors which may cause nurses to miss or ration this care . By addressing these factors we can support nurses to ensure their infection prevention and control practices are up-to-date and appropriate for the times we live in . Nurses , as a professional group have stepped up during this pandemic , as in others , and it should be recognized that infection prevention and control guidelines offer protection to our healthcare workers as well as our patients . Tait et al . ( 2000 ) note that the AIDS epidemic prompted an increase in nurse compliance with infection prevention and control guidelines , the authors of this review suggest COVID-19 may do the same , if nurses are provided with the appropriate supports to enable them to provide safe care . These supports could include enhanced training in decision-making and prioritization , to support nurses to make the right decision around infection prevention and control irrespective of the environment or care context . It is noteworthy that nurses frequently decide to overlook or partially comply with guidelines when they place greater priority on other types of care . The