Variations in infection control practice among Registered Nurses: Investigating best practices

While step-by-step guidance on the performance of infection control behaviors is available, it often does not account for the complexity and competing demands of clinical care in the healthcare environment.  Nurses usually develop patterns of behavior or “work-arounds” which may improve task efficiency but also may reduce the attention to infection control adherence.  Some errors are committed consciously, while other errors are done without awareness of the harm to the nurse or patient.  In a study asking nurses to provide patient care to a simulated patient to evaluate their infection control behaviors related to contact and airborne precautions, a number of variations in practice were noted.  Nurses were recruited through emails and flyers at an academic medical center.  The study included both behavior scoring of video recording and reflective practice inquiry using “Think Aloud” commentary from participants as they reviewed their own performance.  This study identified four common areas of knowledge deficit in terms of infection control practice.  The areas include donning and doffing sequence as well as issues in the use of the respirator, gown, and protective eyewear.  The behavioral and qualitative study findings of this study which outline common knowledge deficits among nurses in these four areas will be used to emphasize important components of the current standards and guidelines to improve patient care at the bedside.  Additional studies are needed to test educational practices that promote safer infection control behaviors by healthcare workers.  The educational emphasis regarding these critical practices should promote both patient and caregiver safety.