Barriers and facilitators to infection prevention and control in Dutch residential care facilities for people with intellectual and developmental disabilities: A theory-informed qualitative study

Abstract

Background Care institutions are recognised to be a high-risk setting for the emergence and spread of infections and antimicrobial-resistant organisms, which stresses the importance of infection prevention and control (IPC). Accurate implementation is crucial for optimal IPC practice. Despite the wide promotion of IPC and research thereof in the hospital and nursing home setting, similar efforts are lacking in disability care settings. Therefore, this study aimed to assess perceived barriers and facilitators to IPC among professionals working at residential care facilities (RCFs) for people with intellectual and developmental disabilities (IDD), as well as to identify professional-reported recommendations to improve IPC. Methods This qualitative study involved semi-structured interviews (before COVID-19) with twelve professionals from five Dutch RCFs for people with IDD. An integrated theoretical approach was used to inform data collection and analysis. Thematic analysis using inductive and deductive approaches was conducted. This study followed the COnsolidated criteria for REporting Qualitative research (COREQ) guidelines. Results Our findings revealed barriers and facilitators at the guideline, client, professional, professional interaction, professional client interaction, client interaction, organisational, community, and societal level. Six main themes covering multiple barriers and facilitators were identified: (1) guidelines’ applicability to (work)setting; (2) professionals’ cognitions and attitude towards IPC (related to educational background); (3) organisational support and priority; (4) educational system; (5) time availability and staff capacity; and (6) task division and change coaches. The main professional-reported recommendations were the introduction of tailored and practical IPC guidelines, structural IPC education and training among all professionals, and client participation. Conclusions To promote IPC, multifaceted and multilevel strategies should be implemented, with a preliminary need for improvements on the guideline, professional, and organisational level. Given the heterogeneous character, i.e., different professionals, clients and care needs, there is a need for a tailored approach to implement IPC and sustain it successfully in disability care. Our findings can inform future IPC practice improvements.

Dupuytren contracture: using qualitative data to inform a conceptual framework for shared decision-making

“…The authors conducted 30 semi-structured interviews via phone call. Previous qualitative studies have shown that a sample size of 12 or more participants is necessary to reach data saturation (Fugard and Potts, 2015; Houben et al., 2021), whereas other qualitative research has demonstrated that sample size requirements for qualitative studies should be study-specific and focus on the quality and richness of the data (Vasileiou et al., 2018). Recruitment of participants in our study continued until saturation was achieved in sentiments among participants belonging to each treatment cohort.…”

Perceived barriers and facilitators to infection prevention and control in Dutch residential care facilities for people with intellectual and developmental disabilities: a cross-sectional study

“…While HCWs play a crucial role in preventing the spread of infectious diseases through individual behavioural changes [ 7 , 9 ], successful IPC requires considering broader multilevel factors [ 10 – 12 ]. These factors — operating at micro, meso, and macro levels — encompass barriers and facilitators that play an important role in shaping the success of IPC efforts [ 11 , 13 – 16 ]. At the micro level, client-related factors, such as a lack of patient education or non-compliance regarding IPC may come into play [ 16 ].…”

“…At the micro level, client-related factors, such as a lack of patient education or non-compliance regarding IPC may come into play [ 16 ]. In addition, interpersonal factors, such as exemplary behaviour among colleagues and HCWs stimulating clients to implement adequate IPC practices can facilitate IPC [ 11 ]. At the meso level, facilities should have clear policies in place to guide IPC practices, such as continuous IPC training programmes [ 11 , 12 ].…”

Health and care workers in long‐term care facilities and their role in preventing emerging infectious diseases: A scoping review

“…This suggests that health and care workers in long-term care facilities are still lacking in core competencies for preventing and controlling emerging infectious diseases. Unfortunately, there are limited studies on infection prevention recommendations for health and care workers, such as the study of Houben et al (2021) on the barriers and facilitators of infection prevention and control in residential care facilities in the Netherlands.…”

“…Unfortunately, there are limited studies on infection prevention recommendations for health and care workers, such as the study of Houben et al. (2021) on the barriers and facilitators of infection prevention and control in residential care facilities in the Netherlands.…”