Dirt and disgust as key drivers in nurses' infection control behaviours: an interpretative, qualitative study

Infection prevention remains a significant challenge for healthcare systems. Yet despite considerable work to provide clear policies and scientifically proven techniques to reduce infection transmission, beliefs and practices of healthcare workers do not always concur with scientific rationale.

To provide explanations for nurses' infection prevention behaviours.

An interpretative, qualitative approach was taken using semi-structured interviews. Twenty interviews with registered nurses working in an acute hospital setting were conducted. Analysis was conducted using the Framework method.

This paper focuses on the theme 'protection from dirt'. Within the findings clear distinction was made between infection and dirt. Fear of contact with dirt, particularly dirt belonging to those who were unknown, was a key driver in behaviour carried out to reduce threat. Familiarity with the patient resulted in a reduction of the protective behaviours required. These behaviours, which initially appeared as part of an infection prevention strategy, were primarily a form of self-protection from patients, who at first encounter were considered as dirty.

Behaviours do not always fit with a rational response to infection, but instead may be responses to dirt. Any programme that simply attempts to address scientific knowledge and behaviour deficits is unlikely to have the desired goals if it does not take into account existing social constructions of dirt and the response it evokes.