Nursing issues Qualitative study—other
Infection control practice: interview with 20 nurses reveals themes of rationalising their own behaviour and justifying any deviations from policy
interviews were undertaken with 20 registered nurses studying part-time at a university in London. All participants were employed in acute hospitals and had been qualified for atleast a year. A topic guide and vignettes were used to obtain the data. The interviews were digitally recorded, transcribed verbatim and analysed using the Framework approach.2
Findings
Dinah Gould
The findings indicated that the nurses rationalised their own behaviour even when they knew that it did not accord with recommended practice. They were eager to give a good impression of their own infection prevention behaviour and present themselves as knowledgeable practitioners. However, they criticised deviations in other nurses’ infection prevention behaviour as irrational or as a means of self-protection when no risk existed. Leading infection prevention practice by example for other nurses and for patients also emerged as an important theme.
School of Healthcare Sciences, Cardiff University, Cardiff, UK
Commentary
Correspondence to: Professor Dinah Gould, School of Healthcare Sciences, Cardiff University, Eastgate House, Newport Road, Cardiff CF24 OAB, UK; [email protected]
The study obtained in-depth data from a small sample of one group of health workers to explore their beliefs and self-reported behaviours about the important topic of infection prevention. The sample consisted of nurses studying at one university, all employed in acute hospitals where problems of HCAI and antimicrobial resistance are known to be greatest. The value of the study lies in the novel approach taken to solicit nurses’ reasons for failing to adhere to agreed infection prevention policies and guidelines. Nurses rationalised their deviations from the guidance but blamed other nurses for unsafe practice. From the data the authors concluded that a display or ‘show’ was being performed and that this was driven by a desire to appear knowledgeable. This small, exploratory study begins to explain the complexities underlying infection prevention behaviour and highlights the tendency to blame other practitioners for failings in infection prevention practice and absolving themselves of blame.3
10.1136/eb-2014-101882
Commentary on: Jackson C, Lowton K, Griffiths P. Infection prevention as “a show”: a qualitative study of nurses’ infection prevention behaviours. Int J Nurs Stud 2014;51:400–8.
Implications for practice and research ▪ Infection prevention involves complex social behaviour. ▪ Education is unlikely to be sufficient when seeking to improve nurses’ infection prevention practice. ▪ Multifaceted campaigns that include education are more likely to be effective.
Competing interests None.
▪ Further research is needed to identify the beliefs held by other health workers about healthcare-associated infection.
Context
References
Infection prevention is an essential part of health care. Evidence-based guidelines have been developed to prevent and control the spread of healthcare-associated infections (HCAIs), but some behaviour that occurs in everyday infection prevention practice remains unexplained.1 Examining such behaviour could provide valuable insight to inform new initiatives aimed at improving practice and ensuring patient safety.
1. Pittet D. The lowbury lecture: behaviour in infection control. J Hosp Infect 2004;58:1–13. 2. Ritchie J, Spencer L. Qualitative data analysis for applied policy research. In: Bryman A, Burgess RC. eds. Analysing qualitative data. London: Routledge, 1994:173–94. 3. Morrow E, Griffiths P, Rao C, et al. ‘Somebody else’s problem?’ Staff attributions of cause and risk of methicillin-resistant Staphylococcus aureus. Am J Infect Control 2011;39:284–91.
Methods The purpose of the study was to answer the research question: ‘How can nurses’ infection prevention behaviour be explained?’ Semistructured
Evid Based Nurs April 2015 | volume 18 | number 2 |
59
Copyright of Evidence Based Nursing is the property of BMJ Publishing Group and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
Infection control practice: interview with 20 nurses reveals themes of rationalising their own behaviour and justifying any deviations from policy
interviews were undertaken with 20 registered nurses studying part-time at a university in London. All participants were employed in acute hospitals and had been qualified for atleast a year. A topic guide and vignettes were used to obtain the data. The interviews were digitally recorded, transcribed verbatim and analysed using the Framework approach.2
Findings
Dinah Gould
The findings indicated that the nurses rationalised their own behaviour even when they knew that it did not accord with recommended practice. They were eager to give a good impression of their own infection prevention behaviour and present themselves as knowledgeable practitioners. However, they criticised deviations in other nurses’ infection prevention behaviour as irrational or as a means of self-protection when no risk existed. Leading infection prevention practice by example for other nurses and for patients also emerged as an important theme.
School of Healthcare Sciences, Cardiff University, Cardiff, UK
Commentary
Correspondence to: Professor Dinah Gould, School of Healthcare Sciences, Cardiff University, Eastgate House, Newport Road, Cardiff CF24 OAB, UK; [email protected]
The study obtained in-depth data from a small sample of one group of health workers to explore their beliefs and self-reported behaviours about the important topic of infection prevention. The sample consisted of nurses studying at one university, all employed in acute hospitals where problems of HCAI and antimicrobial resistance are known to be greatest. The value of the study lies in the novel approach taken to solicit nurses’ reasons for failing to adhere to agreed infection prevention policies and guidelines. Nurses rationalised their deviations from the guidance but blamed other nurses for unsafe practice. From the data the authors concluded that a display or ‘show’ was being performed and that this was driven by a desire to appear knowledgeable. This small, exploratory study begins to explain the complexities underlying infection prevention behaviour and highlights the tendency to blame other practitioners for failings in infection prevention practice and absolving themselves of blame.3
10.1136/eb-2014-101882
Commentary on: Jackson C, Lowton K, Griffiths P. Infection prevention as “a show”: a qualitative study of nurses’ infection prevention behaviours. Int J Nurs Stud 2014;51:400–8.
Implications for practice and research ▪ Infection prevention involves complex social behaviour. ▪ Education is unlikely to be sufficient when seeking to improve nurses’ infection prevention practice. ▪ Multifaceted campaigns that include education are more likely to be effective.
Competing interests None.
▪ Further research is needed to identify the beliefs held by other health workers about healthcare-associated infection.
Context
References
Infection prevention is an essential part of health care. Evidence-based guidelines have been developed to prevent and control the spread of healthcare-associated infections (HCAIs), but some behaviour that occurs in everyday infection prevention practice remains unexplained.1 Examining such behaviour could provide valuable insight to inform new initiatives aimed at improving practice and ensuring patient safety.
1. Pittet D. The lowbury lecture: behaviour in infection control. J Hosp Infect 2004;58:1–13. 2. Ritchie J, Spencer L. Qualitative data analysis for applied policy research. In: Bryman A, Burgess RC. eds. Analysing qualitative data. London: Routledge, 1994:173–94. 3. Morrow E, Griffiths P, Rao C, et al. ‘Somebody else’s problem?’ Staff attributions of cause and risk of methicillin-resistant Staphylococcus aureus. Am J Infect Control 2011;39:284–91.
Methods The purpose of the study was to answer the research question: ‘How can nurses’ infection prevention behaviour be explained?’ Semistructured
Evid Based Nurs April 2015 | volume 18 | number 2 |
59
Copyright of Evidence Based Nursing is the property of BMJ Publishing Group and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
