Exploring the challenges with infection control practices among managers in intensive care units in South Africa

摘要

BACKGROUND. The prevention of healthcare-associated infections has become a health priority globally. Patients in intensive care units (ICUs) are at high risk of acquiring these infections, and infection control is particularly important in this environment. Hospital infection control managers as well as ICU nurses and clinical managers have a vital role to play in ensuring good infection control practices within the ICUs. OBJECTIVE. To explore the challenges with infection control practices among managers in ICUs in South Africa. METHODS. An explorative qualitative design was used. Semi-structured interviews were conducted with 11 nurse intensive care managers, 6 clinical intensive care managers, and 5 hospital infection control managers. Content analysis was used to identify themes and sub-themes. RESULTS. Four themes were identified from the data: challenges with human resources, leadership and governance, infrastructure and equipment, and discrepancies between different categories of healthcare workers. Infection control and nurse managers felt overburdened with work responsibilities which took their time away from infection control in the ICU. Shortage of clinical and nursing staff , insufficient isolation rooms and equipment also presented challenges to implementing adequate infection control measures. Many participants viewed doctors as not being adherent to infection control practices. CONCLUSION. We identified modifiable challenges to infection control in the intensive care setting. Strategies such as ongoing and regular in-service training on infection control for all cadres of healthcare workers is one of the interventions that can be applied to improve infection control in ICUs. The issue of staff shortages and inadequately trained staff must be addressed at a provincial and national level. It is imperative that hospital managers work with their staff to develop strategies to overcome the challenges in implementing and maintaining good infection practices in ICUs.