Exploring the context for effective clinical governance in infection control

Area of Science:

• Healthcare Management
• Infection Prevention and Control
• Clinical Governance

Background:

• Effective clinical governance is vital for advancing infection control practices.
• Historically, focus has been on evidence-based policy and surveillance, with less attention to organizational factors influencing infection preventionists (IPs).

Purpose of the Study:

• To explore how contextual and organizational factors impact IPs' engagement with evidence-based practice and clinical governance.
• To identify challenges faced by IPs in implementing effective infection control.

Main Methods:

• A cross-sectional, web-based survey of IPs in Australia and New Zealand was conducted.
• Survey questions assessed engagement with evidence-based practice and perceptions of organizational context, culture, and leadership.
• Responses were analyzed using Scally and Donaldson's clinical governance framework.

Main Results:

• 300 surveys were returned, indicating IPs are individually capable of evidence-based practice.
• Significant challenges to clinical governance include organizational leadership issues and resistance to infection control.
• Lack of IT solutions, specialist expertise, and financial resources also pose challenges.

Conclusions:

• Enhancing organizational-level contextual factors is key to supporting evidence-based practice in infection control.
• Addressing leadership and resource limitations will sustain current infection control successes and drive further improvements.
• Focusing on the organizational environment is essential for robust clinical governance in infection prevention.