‘There we are failing’ … Infection prevention practices associated factors among nurses working in public and private newborn units in Kenyan hospitals

Abstract

Abstract Background: Small and sick newborns continue to die in low- and middle-income countries as a result of among other causes, infection. Despite the existence of guidelines for infection prevention, little is known on practices and associated factors among nurses working in newborn units in many developing nations. Therefore, the objective of this study was to assess nurses’ practices and their perspectives on what influences their ability to adhere to infection prevention and control (IPC) norms in newborn units.Methods This qualitative study used an ethnographic research design to collect data. 150 hours of observations and through purposeful sampling, nurses working in the newborn units in three hospitals in Nairobi were interviewed using an interview guide. The face to face interviews lasted between 45-60 mins and were digitally audiotaped, transcribed verbatim and translated into English where necessary. Data were imported into Nvivo 10 software for management. All data were anonymised and subjected to thematic analysis.Results A total of 10 nurses from public, 11 from private and 8 from faith-based hospitals participated in the study. Structural organization factors such as proper ward layout, adequate staffing, controlled access of visitors on the ward, involvement of a security officer and presence of an isolation room were factors that facilitated nurses’ observance of infection control on the newborn units. On the other hand, overcrowding, absence of isolation room, improper ward layout, absence of hand hygiene resources, and uncontrolled presence of visitors and lack of enforcement of IPC protocol acted as barriers to non-adherence to IPC.Conclusions Knowledge of Infection prevention and control procedures among nurses may be necessary but are unlikely to be sufficient to deliver improved care. A deliberate investment in organization factors to improve the work environment can facilitate nurses’ ability to provide quality newborn care.</jats:p