Infection control nurses' perceptions of the Code of Hygiene

The aim of the study was to understand senior infection prevention and control nurses' experiences and perceptions of implementing the day to day aspects of the Code of Hygiene.

The Code of Hygiene is legislative and sets out compliance standards in order to reduce infection rates. It details standards by which health-care providers failing to comply with infection control standards can be subject to improvement notices and actions.

Senior nurses from five infection prevention and control teams in England participated in taped, qualitative interviews which were analysed.

Two themes emerged from the data: 'Interventions' and 'Barriers to compliance'. Interventions were driven by senior NHS managers and necessitated organizational change. It was senior NHS managers who were considered as being the force for change and who intervened and took responsibility for implementation. Change was achieved by a top-down approach and was driven by senior managers' fear of external censure. At the same time, participants felt they had more authority as a consequence of these changes as they too, felt they could enforce change. Barriers to compliance were identified as: a lack of facilities, specifically a lack of side rooms and isolation facilities, and the non-engagement of medical staff.

Compliance was achieved by organizational change and senior managerial intervention. Barriers to compliance must be addressed to meet the Code of Hygiene's compliance criteria.