title: Perceived barriers to infection prevention and control for nursing home certified nursing assistants: a qualitative study.
abstract: Healthcare-associated infections, while preventable, result in increased morbidity and mortality in nursing home (NH) residents. Frontline personnel, such as certified nursing assistants (CNAs), are crucial to successful implementation of infection prevention and control (IPC) practices. The purpose of this study was to explore barriers to implementing and maintaining IPC practices for NH CNAs as well as to describe strategies used to overcome these barriers. We conducted a multi-site qualitative study of NH personnel important to infection control. Audio-recorded interviews were transcribed verbatim and transcripts were analyzed using conventional content analysis. Five key themes emerged as perceived barriers to effective IPC for CNAs: 1) language/culture; 2) knowledge/training; 3) per-diem/part-time staff; 4) workload; and 5) accountability. Strategies used to overcome these barriers included: translating in-services, hands on training, on-the-spot training for per-diem/part-time staff, increased staffing ratios, and inclusion/empowerment of CNAs. Understanding IPC barriers and strategies to overcome these barriers may better enable NHs to achieve infection reduction goals.
authors.affiliation: Center for Health Policy, Columbia University School of Nursing, 630 West 168th Street, Mail Code 6, New York, NY 10032, USA. Electronic address: jt2766@columbia.edu.
authors.forename: Jasmine
authors.initials: J
authors.lastname: Travers
authors.affiliation: Center for Health Policy, Columbia University School of Nursing, 630 West 168th Street, Mail Code 6, New York, NY 10032, USA; Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, USA.
authors.forename: Carolyn T A
authors.initials: CT
authors.lastname: Herzig
authors.affiliation: Jefferson School of Nursing, Thomas Jefferson University, 130 South 9th Street, Suite 847, Philadelphia, PA 19107, USA.
authors.forename: Monika
authors.initials: M
authors.lastname: Pogorzelska-Maziarz
authors.affiliation: Center for Health Policy, Columbia University School of Nursing, 630 West 168th Street, Mail Code 6, New York, NY 10032, USA; New York Presbyterian Hospital, New York, NY, USA.
authors.forename: Eileen
authors.initials: E
authors.lastname: Carter
authors.affiliation: Center for Health Policy, Columbia University School of Nursing, 630 West 168th Street, Mail Code 6, New York, NY 10032, USA.
authors.forename: Catherine C
authors.initials: CC
authors.lastname: Cohen
authors.affiliation: Center for Health Policy, Columbia University School of Nursing, 630 West 168th Street, Mail Code 6, New York, NY 10032, USA.
authors.forename: Patricia K
authors.initials: PK
authors.lastname: Semeraro
authors.affiliation: Center for Health Policy, Columbia University School of Nursing, 630 West 168th Street, Mail Code 6, New York, NY 10032, USA.
authors.forename: Ragnhildur I
authors.initials: RI
authors.lastname: Bjarnadottir
authors.affiliation: Center for Health Policy, Columbia University School of Nursing, 630 West 168th Street, Mail Code 6, New York, NY 10032, USA.
authors.forename: Patricia W
authors.initials: PW
authors.lastname: Stone
mesh_terms: D001291:Attitude of Health Personnel; D003428:Cross Infection / Q000517:prevention & control*; D005851:Geriatric Nursing; D006801:Humans; D009735:Nursing Homes; D009740:Nursing Staff
keywords: Certified nursing assistants; Healthcare-associated infections; Infection prevention and control; Nursing homes