An ethnographic study of infection prevention and control practices in a mental health trust
Health care associated infections are high on the National Health Service agendadue to associated increased morbidity and mortality rates and subsequentlyadded pressure of reductionist performance targets. Failure to meet these resultsin financial penalties, cost pressures, litigation and poor public faith andconfidence in non compliant organisations. Studies show many such infectionsare preventable, often resulting from poor compliance with infection preventionand control practices by healthcare workers. Focus to date of this research anddata has been on acute healthcare facilities with little attention to mental healthsettings.This thesis presents the findings of a study based on ethnographic principles,exploring the perceptions of healthcare workers in a mental health care settinginto what affects infection prevention and control practices. The impact of theorganisational culture was the predominant context. Eighteen healthcare workersmeeting the inclusion criteria participated in the study recruited from a largemental health trust in the north west of England, the majority being nurses. Theirexperiences were collected through in-depth, face to face semi-structuredinterviews with participants. These were tape recorded, transcribed verbatim andsubjected to thematic content analysis. Participant observations of discussionsheld during four multi-disciplinary ward rounds were also undertaken. The studyfield was Older People in-patient areas chosen due to increased vulnerability ofthe client group to healthcare associated infections. Field notes were subjectedto thematic analysis. Four overarching themes emerged from the data:experiences of healthcare workers in relation to perceived lack of infectionprevention and control training and education; risks of healthcare associatedinfections to both patients and staff; effect of organisational culture on compliancewith infection prevention and control; importance of leadership and role models inthis area. The findings clearly offer a unique insight into a hitherto unexploredarea in relation to the importance of infection prevention and control within mentalhealth care settings, identifying a need for strategic direction for future policy andpractice.
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