BARRIERS AND FACILITATORS TO INFECTION CONTROL PROCEDURES IN HOSPITAL SETTINGS: A DESCRIPTIVE QUALITATIVE STUDY FROM WESTERN INDIA

Abstract

Background: Healthcare-associated infections (HAIs) represent a significant challenge to patient safety globally, with higher incidence in developing countries. Understanding the barriers and facilitators to infection control implementation in secondary and tertiary care hospitals is essential for improving patient safety. Objectives: This study investigates the barriers and facilitators of infection control procedures in secondary and tertiary care hospitals in Western India and identifies resource constraints and potential managerial interventions. Methods: A descriptive qualitative design was employed. Data were collected through semistructured interviews using the Systems Engineering Initiative for Patient Safety (SEIPS) framework, with 100 healthcare professionals (50 nurses and 50 doctors) from secondary and tertiary care hospitals in Northern Rajasthan. Data were analyzed through thematic analysis with inter-rater reliability checks. Results: Major organizational barriers included lack of resources (65%), inadequate staffing (55%) and inconsistent policies (45%). Environmental barriers encompassed poor infrastructure (35%) and overcrowded wards (45%). High workload and burnout emerged as the most significant individual factor (75%), along with lack of training and awareness (55%). Key facilitators were strong leadership (55%), adequate supplies (65%), effective communication (45%), regular training programs (75%), continuous education (65%) and application of the SEIPS framework (55%). Conclusions: This study reveals the complex interplay of organizational, environmental and individual factors affecting infection control practices. Implementation of targeted interventions addressing resource allocation, staff training, institutional support and standardized protocols is essential. Leveraging technology and establishing multi-level governance structures can enhance infection control effectiveness in resource-limited settings.