title: Translating infection control guidelines into practice: implementation process within a health care institution.
abstract: Health-care-associated infections (HAIs) remain a major patient safety problem even as policy and programmatic efforts designed to reduce HAIs have increased. Although information on implementing effective infection control (IC) efforts has steadily grown, knowledge gaps remain regarding the organizational elements that improve bedside practice and accommodate variations in clinical care settings. We conducted in-depth, semistructured interviews in 11 hospitals across the United States with a range of hospital personnel involved in IC (n = 116). We examined the collective nature of IC and the organizational elements that can enable disparate groups to work together to prevent HAIs. Our content analysis of participants' narratives yielded a rich description of the organizational process of implementing adherence to IC. Findings document the dynamic, fluid, interactional, and reactive nature of this process. Three themes emerged: implementing adherence efforts institution-wide, promoting an institutional culture to sustain adherence, and contending with opposition to the IC mandate.
authors.affiliation: 1New York University, New York, New York, USA.
authors.forename: Victoria H
authors.initials: VH
authors.lastname: Raveis
authors.forename: Laurie J
authors.initials: LJ
authors.lastname: Conway
authors.forename: Mayuko
authors.initials: M
authors.lastname: Uchida
authors.forename: Monika
authors.initials: M
authors.lastname: Pogorzelska-Maziarz
authors.forename: Elaine L
authors.initials: EL
authors.lastname: Larson
authors.forename: Patricia W
authors.initials: PW
authors.lastname: Stone
mesh_terms: D003428:Cross Infection / Q000517:prevention & control*; D006287:Health Planning Guidelines; D006761:Hospitals; D006801:Humans; D017053:Infection Control / Q000458:organization & administration* / Q000592:standards*; D015279:Organizational Culture; D061214:Patient Safety / Q000592:standards; D010564:Personnel, Hospital / Q000193:education / Q000592:standards; D058996:Quality Improvement / Q000458:organization & administration; D014481:United States
keywords: content analysis; health care, culture of; illness and disease, infectious; quality improvement; safety, patient