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. 2012 Mar 7;2(2):e000511.
doi: 10.1136/bmjopen-2011-000511. Print 2012.

Barriers and bridges to infection prevention and control: results of a qualitative case study of a Netherlands' surgical unit

Chantal Backman  1 , Patricia B Marck, Naomi Krogman, Geoff Taylor, Anne Sales, Marc J M Bonten, Ada C M Gigengack-Baars
Affiliations

Barriers and bridges to infection prevention and control: results of a qualitative case study of a Netherlands' surgical unit

Chantal Backman et al. BMJ Open. .

Abstract

Objectives: The objectives of the study are to observe the overall work environment including infection prevention and control (IP&C) practices on the target surgical unit; to analyse the policies and procedures in the hospital and unit environments; to analyse the barriers and bridges to IP&C that practitioners identify in visual narratives of their unit environment and to collect monthly specific IP&C-related anonymised data.

Design: In this qualitative case study analysis, a socio-ecological approach on health systems informed the research design and provided a framework to better understand the complexity of implementing effective IP&C.

Setting: The study was conducted on a surgical unit at a Netherlands' hospital that reported successful reductions in the prevalence of targeted multidrug-resistant organisms.

Methods: Research methods included unit observations (n=3), review of relevant policies and procedures, five practitioner-led photo walkabouts of the unit (n=7), three photo elicitation focus groups with practitioners (n=13) and the review of related IP&C data.

Results: The findings indicate some conditions and processes present that may influence the low prevalence of multidrug-resistant organisms, including the 'search and destroy' active surveillance strategy, low occupancy rates, a centralised bed cleaning system and the presence of an active grass roots Hygiene in Practice group, which engages practitioners in several ongoing activities to promote IP&C on the units.

Conclusions: Further research on the benefits of practitioner-led community of practices on IP&C practices such as the Hygiene in Practice group is also recommended. Additional case studies to compare theses practices with other acute care hospital around the world would be a valuable way to better understand what IP&C programmes are most effective in which contexts and for what reasons. Further data are available by contacting the primary author directly.

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Conflict of interest statement

Competing interest None.

Figures

Figure 1
Figure 1
Hand hygiene station outside of patient room (MGMT-2).
Figure 2
Figure 2
Green storage box for patient (MGMT-41).
Figure 3
Figure 3
Poster (Hygiene in Practice (HIP) group) (NURS-19).
See this image and copyright information in PMC

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