ArticleBMC health services research2022
What is needed to sustain improvements in hospital practices post-COVID-19? a qualitative study of interprofessional dissonance in hospital infection prevention and control.
Article in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Knowledge, practices, educational needs and hospital engagement in Infection Prevention and Control (IPC) among Italian healthcare workers and students: results from a national multicentre survey.JAC-antimicrobial resistance · 2025Article
- Construction of an Index System of the Biosafety Incident Response Capability for Nursing Staff: A Delphi Study.Nursing open · 2025Article
- 'We tried our best... it wasn't great': a qualitative study of clinician experiences on child psychiatry wards at the height of COVID-19.BMC health services research · 2024Article
- Effectiveness of inspector mechanism for the emergency infection prevention and control in the SARS-CoV-2 epidemic period: a self-control real-word study.BMC infectious diseases · 2023Article
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Abstract
backgroundHospital infection prevention and control (IPC) depends on consistent practice to achieve its purpose. Standard precautions are embedded in modern healthcare policies, but not uniformly observed by all clinicians. Well-documented differences in attitudes to IPC, between doctors and nurses, contribute to suboptimal IPC practices and persistence of preventable healthcare-associated infections. The COVID-19 pandemic has seriously affected healthcare professionals' work-practices, lives and health and increased awareness and observance of IPC. Successful transition of health services to a 'post-COVID-19' future, will depend on sustainable integration of lessons learnt into routine practice.
methodsThe aim of this pre-COVID-19 qualitative study was to investigate factors influencing doctors' IPC attitudes and practices, whether they differ from those of nurses and, if so, how this affects interprofessional relationships. We hypothesised that better understanding would guide new strategies to achieve more effective IPC. We interviewed 26 senior clinicians (16 doctors and 10 nurses) from a range of specialties, at a large Australian tertiary hospital. Interview transcripts were reviewed iteratively, and themes identified inductively, using reflexive thematic analysis.
resultsParticipants from both professions painted clichéd portraits of 'typical' doctors and nurses and recounted unflattering anecdotes of their IPC behaviours. Doctors were described as self-directed and often unaware or disdainful of IPC rules; while nurses were portrayed as slavishly following rules, ostensibly to protect patients, irrespective of risk or evidence. Many participants believed that doctors object to being reminded of IPC requirements by nurses, despite many senior doctors having limited knowledge of correct IPC practice. Overall, participants' comments suggested that the 'doctor-nurse game'-described in the 1960s, to exemplify the complex power disparity between professions-is still in play, despite changes in both professions, in the interim.
conclusionsThe results suggest that interprofessional differences and inconsistencies constrain IPC practice improvement. IPC inconsistencies and failures can be catastrophic, but the common threat of COVID-19 has promoted focus and unity. Appropriate implementation of IPC policies should be context-specific and respect the needs and expertise of all stakeholders. We propose an ethical framework to guide interprofessional collaboration in establishing a path towards sustained improvements in IPC and bio-preparedness.
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