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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.
Background:
Infection prevention and control (IPC) behaviors among healthcare workers are influenced by multiple components and complex features of the work system. Complexity refers to the multicomponent, non-linear, and context-dependent characteristics of system elements, and is increasingly recognized as a key feature of healthcare delivery. However, evidence on the role of IPC complexity in these relationships remains limited.
Methods:
A cross-sectional survey was conducted in 3 branch hospitals of a tertiary hospital in Wuhan, China. A total of 833 healthcare workers completed a structured questionnaire assessing IPC person, organization, tools and technology, tasks, internal environment, external environment, IPC complexity, and IPC behaviors based on Systems Engineering Initiative for Patient Safety (SEIPS) model. Structural equation modeling and bias-corrected bootstrap analyses were used to evaluate direct and indirect associations.
Results:
IPC complexity (β= 0.106, P=0.048) positively associated with IPC behaviors. IPC tasks (β= 0.172, P=0.003) and internal environment (β= 0.221, P<0.001) directly associated with IPC behaviors; IPC person (95% CI:0.001-0.033, P=0.015), internal environment (95% CI:0.009-0.088, P=0.015) and external environment (95% CI:0.007-0.075, P=0.018) indirectly associated with IPC behaviors through the complexity.
Conclusion:
IPC behaviors were linked to multiple work system factors, with complexity serving as an important intermediate correlate. Efforts to improve IPC practice should address task demands, environmental support, and perceived work complexity rather than focusing on individual behaviors alone.
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