Exploring infection prevention practices in home-based nursing care: A qualitative observational study

Area of Science:

• Healthcare Management
• Infection Control
• Nursing Practice

Background:

• Home-based nursing care is expanding, serving older clients with complex conditions and numerous medical devices.
• Infection prevention presents significant challenges for nurses, caregivers, and clients in home settings.

Purpose of the Study:

• To explore infection prevention practices in home-based nursing care.
• To identify behavioral factors influencing these practices among nurses and clients.
• To determine barriers and facilitators to effective infection prevention.

Main Methods:

• Qualitative, exploratory design utilizing participant observations.
• Data collection supplemented with focus group discussions and semi-structured interviews.
• Involved 16 nurses, 3 professional caregivers, and 80 clients across four Dutch healthcare organizations.

Main Results:

• Observed suboptimal infection prevention practices in 87 care situations.
• Identified challenges including autonomous environments, variable hand hygiene and PPE use, and communication device hygiene.
• Noted inadequate organizational support, fragmented guidelines, and conflicting protocols.

Conclusions:

• Daily infection prevention in home care is suboptimal, with significant variations in practice.
• Barriers include work environment, professional performance, client factors, and organizational support.
• Facilitators for improved infection prevention need further investigation and implementation.