School of Medicine and Public Health, University of Wisconsin, Madison, WI.
School of Medicine and Public Health, University of Wisconsin, Madison, WI; William S. Middleton Memorial Veterans Hospital, Madison, WI.
Am J Infect Control. 2017 Oct 1;45(10):1064-1068. doi: 10.1016/j.ajic.2017.05.002. Epub 2017 Jul 25.
Health care-associated infections (HAIs) are largely preventable, but are associated with considerable health care burden. Given the significant cost of HAIs, many health care institutions have implemented bundled interventions to reduce HAIs. These complex behavioral interventions require considerable effort; however, individual behaviors and motivations crucial to successful and sustained implementation have not been adequately assessed. We evaluated health care worker motivations to reduce HAIs.
This was a phenomenologic qualitative study of health care workers in different roles within a university hospital, recruited via a snowball strategy. Using constructs from the Consolidated Framework for Implementation Research model, face-to-face semi-structured interviews were used to explore perceptions of health care worker motivation to follow protocols on HAI prevention.
Across all types of health care workers interviewed, patient safety and improvement in clinical outcomes were the major motivators to reducing HAIs. Other important motivators included collaborative environment that valued individual input, transparency and feedback at both organizational and individual levels, leadership involvement, and refresher trainings and workshops. We did not find policy, regulatory considerations, or financial penalties to be important motivators.
Health care workers perceived patient safety and clinical outcomes as the primary motivators to reduce HAI. Leadership engagement and data-driven interventions with frequent performance feedback were also identified as important facilitators of HAI prevention.
医疗保健相关感染（HAI）在很大程度上是可以预防的，但会给医疗保健带来相当大的负担。鉴于 HAI 的巨大成本，许多医疗机构已经实施了捆绑干预措施来降低 HAI。这些复杂的行为干预措施需要付出大量努力；然而，对于成功和持续实施至关重要的个人行为和动机尚未得到充分评估。我们评估了医疗保健工作者减少 HAI 的动机。
这是一项针对大学医院不同角色的医疗保健工作者的现象学定性研究，通过滚雪球策略招募。使用实施研究综合框架模型中的构建，我们使用面对面的半结构化访谈来探讨医疗保健工作者对预防 HAI 协议的遵守意愿的动机。
在接受采访的所有类型的医疗保健工作者中，患者安全和改善临床结果是减少 HAI 的主要动机。其他重要的动机包括重视个人投入的协作环境、组织和个人层面的透明度和反馈、领导力参与，以及更新培训和研讨会。我们没有发现政策、监管考虑因素或财务处罚是重要的动机。
医疗保健工作者认为患者安全和临床结果是减少 HAI 的主要动机。领导力参与和数据驱动的干预措施以及频繁的绩效反馈也被确定为 HAI 预防的重要促进因素。
