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Challenging community nurse beliefs key to improving infection control, suggests survey

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Community nurse beliefs about infection prevention influence whether they comply with prevention protocols more than their actual knowledge of how to comply, according to new US research.

Based on these findings, the researchers suggested that altering perceptions about infection risk among staff was a promising strategy for improving compliance with infection control procedures.

“Nurses play a critical role in infection control in home healthcare settings”

David Russell

The team of researchers from Columbia University and the Visiting Nurse Service of New York surveyed 359 home healthcare nurses at two large agencies in the north eastern United States.

While participants self-reported high levels of both infection control compliance and knowledge, the survey results showed that the two factors were not significantly associated.

By contrast, the researchers said their survey indicated that nurse compliance may be driven more by subjectively held information than by the accuracy of knowledge.

It suggested that infection control strategies should include targeting the perception of workers by challenging existing beliefs – a tactic that has proven effective in promoting hand hygiene, they said.

Among the findings were that only 68.5% of nurses in the sample agreed that the influenza vaccine was safe.

Similarly, only 60.4% of nurses said their agency employer made it easy for them to stay home when they were sick.

“Efforts to improve compliance need to update knowledge and target common misperceptions”

Janet Haas

These results suggested that home healthcare agencies may benefit from better educating staff on the influenza vaccine and employee sick leave policies, noted the researchers.

While the survey results suggested that respondents had adequate knowledge about standard precautions to prevent the transmission of infection and protocols for handling exposure to bodily fluids, respondents were less knowledgeable about nursing bags and hand hygiene practices.

For instance, more than a quarter of the nurses surveyed failed to identify that hand hygiene should be performed after touching a nursing bag.

In addition, nearly 90% did not recognise that a nursing bag should have at least three separate compartments to segregate multi-use items from single-use items, and that hand hygiene supplies must be stored in a separate part, so hands could be cleaned before entering other compartments.

“These gaps in knowledge are notable considering that that the nursing bag could potentially serve as a vector for transporting infectious pathogens between home healthcare patients,” said the researchers.

They added that all survey respondents reported compliance with wearing gloves when anticipating contact with body fluids or blood products.

Lead study author Dr David Russell, from the Visiting Nurse Service of New York, said: “Nurses play a critical role in infection control in home healthcare settings.

Association for Professionals in Infection Control and Epidemiology (APIC)

Janet Haad

Janet Haas

“Moving beyond a singular focus of knowledge by sharing messages that challenge perceptions on topics – from the influenza vaccine to proper handling of nursing bags – may go a long way toward enhancing compliance with effective infection control strategies,” he said.

The study was published in the American Journal of Infection Control, the journal of the Association for Professionals in Infection Control and Epidemiology (APIC).

APIC president Dr Janet Haas said: “This study demonstrates the importance of understanding and addressing home healthcare nurses’ misperceptions about infection control measures.

“Efforts to improve compliance need to update knowledge and target common misperceptions in order to reinforce proven methods of infection prevention and control,” she added.

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