Madran Bahar, Demir Zeynep Ilgin, Yalcin Busra, Ayaz Oguz Taha, Iyikosker Kaan, Keskin Aleyna, Gorel Azra, Aksoy Yunus, Sagaltici Nilayda, Hacioglu Koray, Kayi Ilker, Ergönül Önder, Sakarya Sibel, Keske Şiran
School of Medicine, Public Health Department, Koç University, Topkapi, Istanbul, Türkiye, Turkey.
Koç University Isbank Center for Infectious Disease Research Center, Istanbul, Türkiye.
Antimicrob Resist Infect Control. 2025 Jun 23;14(1):71. doi: 10.1186/s13756-025-01544-3.
In EU countries, 33,000 people die of antibiotic-resistant infections annually, and Türkiye is one of the countries with the highest rate of antimicrobial resistance. More than 70% of these infections are directly related to healthcare-associated infections (HAIs). Implementing IPC measures is critical to preventing HAIs in ICUs, with the highest risk of HAIs. However, compliance with IPC measures by HCWs is suboptimal. In this study, we aimed to identify the barriers to compliance with infection prevention and control (IPC) measures in intensive care units (ICUs) and to find solutions by interviewing healthcare workers (HCWs).
The study used a qualitative approach with in-depth face-to-face interviews. Between March 1 and May 31, 2024, 20 HCWs were interviewed in five tertiary hospitals in Istanbul. Purposive sampling included at least three HCWs from each hospital: an IPC nurse or physician, an ICU physician, and an ICU nurse. The conceptual framework of the semi-structured interview guide was based on the Health Belief Model (HBM).
The majority of HCWs were aware of the importance and benefits of IPC measures; however, none reported full compliance. A significant proportion of HCWs (n = 16) reported that in-service training programs conducted by infection control committees were not effective enough to positively influence staff behaviuor. Increased workload (n = 13) and unexpected medical emergencies interrupting IPC activities (n = 13) were also cited as barriers to compliance. More than half of respondents indicated that increased sanctions (n = 11), stricter control mechanisms (n = 11), and more effective IPC training programs (n = 11) would help improve compliance rates.
Addressing barriers and implementing tailored solutions can significantly enhance compliance. By integrating innovative training programs, improving working conditions, and strengthening enforcement mechanisms, hospital administrators and IPC committees can foster a safer environment for patients, HCWs, and the broader community.
在欧盟国家,每年有3.3万人死于抗生素耐药性感染,而土耳其是抗菌药物耐药率最高的国家之一。这些感染中超过70%与医疗保健相关感染(HAIs)直接相关。实施感染预防与控制(IPC)措施对于预防重症监护病房(ICU)中感染风险最高的HAIs至关重要。然而,医护人员对IPC措施的依从性并不理想。在本研究中,我们旨在通过采访医护人员(HCWs)来确定重症监护病房(ICU)中感染预防与控制(IPC)措施依从性的障碍,并找到解决方案。
本研究采用定性方法,进行深入的面对面访谈。2024年3月1日至5月31日期间,在伊斯坦布尔的五家三级医院对20名医护人员进行了访谈。目的抽样包括每家医院至少三名医护人员:一名IPC护士或医生、一名ICU医生和一名ICU护士。半结构化访谈指南的概念框架基于健康信念模型(HBM)。
大多数医护人员意识到IPC措施的重要性和益处;然而,没有人报告完全依从。相当一部分医护人员(n = 16)报告称,感染控制委员会开展的在职培训项目不足以对员工行为产生积极影响。工作量增加(n = 13)和意外医疗紧急情况打断IPC活动(n = 13)也被认为是依从性的障碍。超过一半的受访者表示,增加制裁(n = 11)、更严格的控制机制(n = 11)和更有效的IPC培训项目(n = 11)将有助于提高依从率。
解决障碍并实施量身定制的解决方案可显著提高依从性。通过整合创新培训项目、改善工作条件和加强执行机制,医院管理人员和IPC委员会可为患者、医护人员和更广泛的社区营造更安全的环境。