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Using a Human Factors Framework to Examine Complexity as a Mediator Between IPC Work System and Healthcare Workers'
Qian Zhou1, Junjie Liu2, Li Nie3
1Department of Hospital Infection Management, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
Infection and Drug Resistance
|July 26, 2026
Summary
Infection prevention and control (IPC) complexity positively influences healthcare worker behaviors. Improving IPC requires addressing task demands and environmental support, not just individual actions.
Area of Science:
- Healthcare management
- Patient safety
- Systems engineering
Background:
- Infection prevention and control (IPC) behaviors are complex and influenced by work systems.
- The role of IPC complexity in healthcare delivery is not well understood.
- Healthcare systems are increasingly recognized for their complex, non-linear, and context-dependent characteristics.
Purpose of the Study:
- To investigate the relationship between work system factors, IPC complexity, and IPC behaviors among healthcare workers.
- To evaluate the direct and indirect associations of various system components with IPC behaviors.
- To understand the mediating role of IPC complexity in the association between work system factors and IPC behaviors.
Main Methods:
- A cross-sectional survey was conducted with 833 healthcare workers in Wuhan, China.
- The Systems Engineering Initiative for Patient Safety (SEIPS) model was used to assess work system components.
- Structural equation modeling and bias-corrected bootstrap analyses were employed to examine associations.
Main Results:
- IPC complexity showed a positive association with IPC behaviors (β=0.106, P=0.048).
- IPC tasks (β=0.172, P=0.003) and internal environment (β=0.221, P<0.001) directly predicted IPC behaviors.
- Person, internal, and external environments indirectly influenced IPC behaviors through complexity.
Conclusions:
- IPC behaviors are associated with multiple work system factors, with complexity acting as a key mediator.
- Improving IPC practices necessitates a holistic approach, considering task demands, environmental support, and perceived complexity.
- Focusing solely on individual behaviors is insufficient; systemic factors are crucial for enhancing IPC outcomes.
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