Barriers and bridges to infection prevention and control: results of a case study of a Canadian surgical unit

Title: Barriers and bridges to infection prevention and control: results of a case study of a Canadian surgical unit
Authors: Backman, Chantal
Marck, Patricia Beryl
Krogman, Naomi
Taylor, Geoffrey
Sales, Anne
Roth, Virginia R.
Date: 2011
Abstract: Infection prevention and control (IP&C) of multidrug-resistant organisms is an increasing challenge in hospitals worldwide. Objective In this study, we attempt to identify the barriers and bridges for IP&C on a surgical unit at a large urban Canadian hospital. Methods A socio-ecological perspective on health systems was adapted from work in ecological restoration and healthcare to inform the use of multiple participatory research methods including unit observations (n=3), review of relevant policies and procedures, four practitioner-led photo walkabouts of the unit (n=6), three photo elicitation focus groups with practitioners (n=13), and the review of related IP&C data. Results The findings indicate that despite active management support for IP&C, many challenges exist in the hospital environment. Key barriers included high patient occupancy rate, hospital design, the use of workarounds to adapt to these challenges, several common problematic practices, and the culture of the team or organization. Conclusions These findings confirm many challenges for IP&C that have been outlined in other literature for contemporary acute care environments. For example, to reduce the use of problematic workarounds, staff must be engaged in health system and organizational decision-making processes that affect their workload, workflow, and daily practices on the unit. Yet, the existence of problematic gaps between clinical, organizational, and health system governance has been identified as an issue for safety in healthcare. Additional research is needed to further our knowledge on how communities of researchers, practitioners, managers, and policy makers can collaboratively engage in studying and assessing their environments to design and implement meaningful, sustainable IP&C improvements.
CollectionSciences de la santé // Health Sciences