Abstract
BackgroundHealthcare facilities in low- and middle-income countries, including the Philippines, face substantial challenges in achieving effective infection control. Early stages of interventions should include efforts to understand perceptions held by healthcare workers who participate in infection control programs.MethodsWe performed a qualitative study to examine facilitators and barriers to infection control at an 800-bed, private, tertiary hospital in Manila, Philippines. Semi-structured interviews were conducted with 22 nurses, physicians, and clinical pharmacists using a guide based on the Systems Engineering Initiative for Patient Safety (SEIPS). Major facilitators and barriers to infection control were reported for each SEIPS factor: person, organization, tasks, physical environment, and technology and tools.ResultsPrimary facilitators included a robust, long-standing infection control committee, a dedicated infection control nursing staff, and innovative electronic hand hygiene surveillance technology. Barriers included suboptimal dissemination of hand hygiene compliance data, high nursing turnover, clinical time constraints, and resource limitations that restricted equipment purchasing.ConclusionsThe identified facilitators and barriers may be used to prioritize possible opportunities for infection control interventions. A systems engineering approach is useful for conducting a comprehensive work system analysis, and maximizing resources to overcome known barriers to infection control in heavily resource-constrained settings.
Highlights
Healthcare facilities in low- and middle-income countries, including the Philippines, face substantial challenges in achieving effective infection control
Those in lowand middle-income countries such as the Philippines experience especially high rates of Hospital-acquired infection (HAI) [1, 2], perhaps due to the added challenges they face in achieving effective infection control
The Systems Engineering Initiative for Patient Safety, or SEIPS framework, is well suited for its ability to analyze the impacts of a work system on both patient and organizational outcomes [8]
Summary
Healthcare facilities in low- and middle-income countries, including the Philippines, face substantial challenges in achieving effective infection control. No health care facility in the world is immune to the burden of hospital-acquired infections (HAIs) Those in lowand middle-income countries such as the Philippines experience especially high rates of HAIs [1, 2], perhaps due to the added challenges they face in achieving effective infection control. The work system includes the components of person (e.g. skills, motivation, and needs), tasks (e.g. job content), tools and technologies (e.g. information technologies or medical devices), the physical environment (e.g. layout and work station design), and organizational components (e.g. patient safety culture and communication).
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