Reasons for insufficient compliance with infection prevention and control measures in the intensive care unit: a qualitative study conducted in Türkiye in 2024.

Background: In EU countries, 33,000 people die of antibiotic-resistant infections annually, and Türkiye is one of the countries with the highest rate of antimicrobial resistance. More than 70% of these infections are directly related to healthcare-associated infections (HAIs). Implementing IPC measures is critical to preventing HAIs in ICUs, with the highest risk of HAIs. However, compliance with IPC measures by HCWs is suboptimal. In this study, we aimed to identify the barriers to compliance with infection prevention and control (IPC) measures in intensive care units (ICUs) and to find solutions by interviewing healthcare workers (HCWs).

Methods: The study used a qualitative approach with in-depth face-to-face interviews. Between March 1 and May 31, 2024, 20 HCWs were interviewed in five tertiary hospitals in Istanbul. Purposive sampling included at least three HCWs from each hospital: an IPC nurse or physician, an ICU physician, and an ICU nurse. The conceptual framework of the semi-structured interview guide was based on the Health Belief Model (HBM).

Results: The majority of HCWs were aware of the importance and benefits of IPC measures; however, none reported full compliance. A significant proportion of HCWs (n = 16) reported that in-service training programs conducted by infection control committees were not effective enough to positively influence staff behaviuor. Increased workload (n = 13) and unexpected medical emergencies interrupting IPC activities (n = 13) were also cited as barriers to compliance. More than half of respondents indicated that increased sanctions (n = 11), stricter control mechanisms (n = 11), and more effective IPC training programs (n = 11) would help improve compliance rates.

Conclusions: Addressing barriers and implementing tailored solutions can significantly enhance compliance. By integrating innovative training programs, improving working conditions, and strengthening enforcement mechanisms, hospital administrators and IPC committees can foster a safer environment for patients, HCWs, and the broader community.