Factors influencing healthcare workers’ adherence to infection prevention and control in Saudi Arabia

Awal, Zainab Abduallah A (2025) Factors influencing healthcare workers’ adherence to infection prevention and control in Saudi Arabia. PhD thesis, University of Glasgow.

Abstract

Background: Infection Prevention and Control (IPC) practices have a unique role in reducing the risk of healthcare-associated infections in healthcare settings. However, adherence to IPC practices, including standard precautions, remains suboptimal among healthcare workers. In Saudi Arabia and across the Middle East, research into IPC is growing, especially following the increased global emphasis on infection control due to the COVID-19 pandemic. However, despite this growing interest, there is still a limited understanding of the factors contributing to IPC adherence among healthcare workers, particularly in intensive care units (ICUs) and medical wards. Therefore, the current study aims to address this gap by conducting a multi-method qualitative study to explore the factors affecting adherence to IPC practices among healthcare workers in ICUs and medical wards in Saudi Arabia.

Methods: The research comprised three phases and the empirical work was conducted in two selected hospitals within Saudi Arabia. A qualitative systematic review was first conducted to explore the factors influencing IPC adherence among healthcare workers in Middle Eastern countries (Phase 1). This was followed by two qualitative studies, designed to capture perspectives on IPC practices and potential factors influencing adherence to IPC practices from different perspectives. The first perspective was that of workers (n = 8) who worked in infection control teams in two hospitals in Saudi Arabia, sought through focus groups (Phase 2). This was followed by Phase 3 in which individual semi-structured interviews were conducted to seek perspectives on IPC practices, and their barriers and facilitators in practice, through the lens of healthcare workers (n = 20) delivering hands-on care and employed within ICU and medical wards of the two hospitals.

Findings: Phase 1 of the current study identified organisational and individual factors influencing adherence to IPC practices. Individual factors, including moral principles, ethical beliefs, and cultural habits, played a significant role in promoting IPC adherence. Organisational factors, including leadership, training gaps, and environmental challenges were also perceived to affect adherence. Phase 2 further explored the role of the infection control team in monitoring adherence and providing education and training on IPC practices. The findings from Phase 2 revealed the infection control teams’ perceptions of the main challenges associated with IPC adherence. These challenges included perceived differences in adherence among professional groups and across various components of IPC practices; staff stability; and the nature of each department, including its procedures and the acuity of patients. Phase 3 further supported the findings from the second phase. It highlighted poor leadership and managerial support, and the need for more training, and for involving all healthcare workers as well as patients and their relatives in this training, as major challenges that affected adherence to IPC practices. Overall, the study showed a notable increase in awareness of IPC following the emergence of COVID-19. It also highlighted the role of cultural and social factors in IPC adherence, along with persistent hierarchical challenges within the healthcare system.

Conclusion and implications: This study highlights the importance of organisational support for healthcare workers as well as improving the monitoring strategies in Saudi Arabia. The study recommends enhancing the involvement of family in IPC practices and fostering a supportive working environment through recognition and team-building initiatives. It also emphasises the development of culturally sensitive IPC policies, as well as the establishment of recognition programmes for IPC leaders. Addressing staffing issues and improving the physical work environment are also crucial for maintaining IPC practices. For future research, it is important to explore the impact of culturally sensitive IPC interventions, engaging family members in IPC education, and comparing IPC adherence across various healthcare settings and disciplines to gain a comprehensive understanding of IPC practices and to improve overall adherence.

• Item Type: Thesis (PhD)
• Qualification Level: Doctoral
• Subjects: R Medicine > R Medicine (General); R Medicine > RA Public aspects of medicine
• Colleges/Schools: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Supervisor's Name: McFeely, Dr. Clare and Kidd, Dr. Lisa
• Date of Award: 2025
• Depositing User: Theses Team
• Unique ID: glathesis:2025-85206
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 17 Jun 2025 16:26
• Last Modified: 17 Jun 2025 16:28
• Thesis DOI: 10.5525/gla.thesis.85206
• URI: https://theses.gla.ac.uk/id/eprint/85206