Nurses’ Attitudes Can Determine Infection Control Compliance

Infection is a leading cause of hospitalization among home health care patients, yet relatively little is known about nurses’ compliance with infection control practices. That’s beginning to change, and early findings suggest attitude toward infection control compliance has an enormous impact.

Researchers at The University of Manchester, Columbia University and Appalachian State University teamed up with the Visiting Nurse Service of New York (VNSNY) to study how attitudes among community nurses impact compliance with infection control. Results of the study, based on a self-reported survey of more than 350 community nurses, were published June 14 in the American Journal of Infection Control.

“Home health care is rapidly growing, especially in the last few decades,” Jingling Shang, an assistant professor of nursing at the Columbia University School of Nursing, told Home Health Care News. “However, there have been few studies conducted … regarding infection control and prevention [in that space].”


Among their findings, researchers determined that home health care nurses’ level of compliance with infection control practices was strongly associated with more favorable attitudes, even more so than their overall experience or knowledge from time spent working in home health. Along those same lines, researchers found that improving compliance with infection control practices in home health would likely require targeted strategies to alter attitudes and perceptions of nursing staff.

In other words, when nurses see infection control as an important part of their job, they do a better job of being compliant.

“When looking at the association between knowledge and attitude with compliance, we found that attitude is the one that actually affects compliance rates,” Shang said. “The top message is [looking at] what the agency administrator can do to improve compliance, and I think it’s taking the approach of improving … nurses’ attitudes.”


Surveyed nurses all worked for VNSNY and a large New Jersey-based home health agency.

More than 90% of surveyed nurses reported being compliant with infection control practices. However, only 82% said they wear a disposable face mask whenever there is a possibility of a splash or splatter, and only 79% said they wear a gown if soiling with blood or bodily fluids is likely. Almost all surveyed nurses failed to identify that hand hygiene should be performed after touching their nursing bag, which may transport infectious pathogens between patients.

The research team plans to continue studying the relationship between nurses, home health patients and infection control compliance moving forward, Shang said. While the recently published study relies on self-reported survey answers, another effort is currently underway to observe nurses at work and gather more precise, objective data. In the future, the team also plans on researching the role home health agency’s play as well.

“We’ll see from the real work if they’re adhering to infection control compliance,” she said. “We are in the middle of data collection, so hopefully next year we’ll have more data.”

Research was funded by a U.S. Agency for Healthcare Research and Quality grant.

Written by Robert Holly

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