Barriers to Effective Infection Prevention in the Neonatal Intensive Care Unit: A Qualitative Study.

Area of Science:

• Healthcare quality improvement
• Patient safety research
• Neonatal care

Background:

• Effective infection prevention (IP) behaviors, including hand hygiene (HH) and device disinfection, are vital for critically ill neonates.
• Reducing infection transmission from family members and hospital staff is a key concern in neonatal intensive care units (NICUs).

Purpose of the Study:

• To identify perceptions and barriers related to IP behaviors among neonatal nurses and patient family members.
• To inform the development of educational interventions aimed at improving IP practices for both staff and families.

Main Methods:

• Qualitative study utilizing focus groups with neonatal nurses and patient family members.
• Data triangulation with hospital-wide survey results.
• Inductive content analysis of gathered qualitative data.

Main Results:

• Identified communication challenges between staff and families regarding IP education, particularly "just-in-time" hand hygiene (HH) reminders.
• Stakeholders reported discomfort with the timing and nature of HH education, contributing to increased stress in the NICU.
• Survey data corroborated the findings on communication barriers and their impact.

Conclusions:

• Improving communication strategies between patient families and frontline staff is essential for enhancing IP behaviors.
• Reducing the burden on nurses for providing HH reminders through enhanced IP education can decrease stress and improve patient outcomes.
• Further research is needed to optimize the delivery and timing of educational interventions targeting stakeholder communication in IP.