A Qualitative Examination of Interprofessional Teamwork for Infection Prevention: Development of a Model and Solutions

Abstract

Health care-associated infections (HAIs), such as central line-associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs), are associated with patient mortality and high costs to the health care system. These are largely preventable by practices such as prompt removal of central lines and Foley catheters. While seemingly straightforward, these practices require effective teamwork between physicians and nurses to be enacted successfully. Understanding the dynamics of interprofessional teamwork in the HAI prevention context requires further examination. We interviewed 420 participants (physicians, nursing, others) across 18 hospitals about interprofessional collaboration in this context. We propose an Input-Mediator-Output-Input (IMOI) model of interprofessional teamwork in the context of HAI prevention, suggesting that various organizational processes and structures facilitate specific teamwork attitudes, behaviors, and cognitions, which subsequently lead to HAI prevention outcomes including timeliness of line and Foley removal, ensuring sterile technique, and hand hygiene. We then propose strategies to improve interprofessional teamwork around HAI prevention.

Keywords: health care–associated infections; infection prevention; interprofessional collaboration; management practices; qualitative methods; teamwork.

Figure 1.

Interprofessional teamwork in the context of HAI prevention. Letters correspond to quotations in Table 1. Stars denote areas that can be directly influenced by management.

Figure 2.

Management practices to support interprofessional teamwork in the context of infection prevention