Nurses' Attitudes Impact Compliance with Infection Control Practice

A study of home health care nurses in the United States has found that attitudes and organizational policies, rather than knowledge base, were much more likely to lead to greater compliance with infection control.

The study, “Factors for Compliance with Infection Control Practices in Home Health Care: Findings from a Survey of Nurses’ Knowledge and Attitudes Toward Infection Control,” is published in the American Journal of Infection Control. The authors are from Columbia University School of Nursing, Visiting Nurse Service of New York, Appalachian State University, and The University of Manchester in England. 

Jingjing Shang, PhD, assistant professor of nursing at Columbia University School of Nursing, who is one of the lead authors said, “Infection is a leading cause of hospitalization among home health care patients, and nurses have a key role in reducing infection by compliance with infection control procedures in the home care setting. This study tells us that knowledge is not enough. Our efforts to improve compliance need to focus on ways to alter nurses’ attitudes and perceptions about infection risk.”

The researchers surveyed 359 home health care nurses in the U.S., analyzing their knowledge of, attitudes toward, and compliance with infection control practices. They examined the relationships between knowledge, attitudes, and compliance.

The percentage of home health nurses who self-reported compliance with infection control practices exceeded 90 percent for most of the measured behaviors. However, knowledge of infection control practices was not associated with compliance. 

Among the findings:

• 81.9 percent said they wear a disposable facemask whenever there is a possibility of a splash or splatter.
• 79 percent said they wear a gown if soiling with blood or bodily fluids is likely.
• 69.6 percent said they wear goggles or an eye shield when there is a possibility of exposure to bloody discharge or fluid.
• Slightly more than two-thirds said that the influenza vaccine is safe (69.9 percent).
• 60.4 percent felt it was easy for them to stay at home when they were sick.
• About 30 percent of respondents failed to identify that hand hygiene should be performed after touching the nursing bag, which may transport infectious pathogens between patients.

From these findings, the authors suggest that efforts to improve compliance with infection control practices in home healthcare should focus on strategies to alter perceptions about infection risk and other attitudinal factors.

The research is funded by the Agency for Healthcare Research and Quality.

A full version of the study can be found here.