Factors Influencing SARS-CoV-2 Infection Control Practices of Nurses Caring for COVID-19 Patients in South Korea: Based on Health Belief Model

Theoretical models applied to understand infection prevention and control practices of healthcare workers during the COVID-19 pandemic: A systematic review

Background

Effective infection prevention and control (IPC) practices among healthcare workers are crucial to prevent the spread of COVID-19 and other infections in healthcare settings.

Aim

To synthesise evidence on behaviour change theories, models, or frameworks applied to understand healthcare workers' IPC practices during the COVID-19 pandemic.

Methods

PubMed, EBSCOhost interface, ProQuest interface, MEDLINE (Ovid), and grey literature were searched for primary studies published between December 2019 and May 2023. The Mixed Method Appraisal Tool evaluated the methodological quality of the studies. Two reviewers independently completed study selection, data extraction, and quality assessment.

Results

The search yielded 2110 studies, of which 19 were included. Seven behaviour change theories, models, and frameworks were identified, with the Health Belief Model and Theoretical Domains Framework being the most employed. Based on these theories, models, and frameworks, the included studies identified cognitive, environmental, and social factors influencing healthcare workers' compliance with COVID-19 IPC practices.

Discussion

This review offers insights into the critical role of behavioural change theories, models, or frameworks in understanding the factors influencing healthcare workers' compliance with IPC practices during COVID-19. It also highlights the potential of these theories in guiding the development of evidence-based interventions to improve healthcare workers' compliance with IPC practices.

Nursing Students' Perceptions of Factors Influencing Nursing Intentions toward COVID-19 Patients

Coronavirus disease (COVID-19) is a pandemic to which nursing students are particularly susceptible. This study aims to comprehensively examine nursing students' knowledge, attitudes, risk perceptions, preventive behaviors related to COVID-19, and nursing intentions toward patients with the virus. A questionnaire was administered to 149 nursing students from two universities. Data on the respondents' general characteristics, knowledge levels, attitudes, perceived risk, preventive behaviors toward COVID-19, and nursing intentions toward COVID-19 patients were collected. The collected data were statistically analyzed using SPSS software (version 26.0). This involved descriptive statistics, independent t-tests, one-way ANOVA, Pearson's correlation coefficient, and stepwise multiple regression analyses. The analyses of the factors affecting nursing students' nursing intentions for COVID-19 patients showed that the most predictive factor was perceived risk (β = -0.38, p < 0.001), followed by attitudes (β = 0.29, p < 0.001) and preventive behaviors (β = 0.17, p = 0.017), which explained 26% of the variance in nursing intentions. Lowering the perceived risk of infectious diseases and cultivating positive attitudes and preventive behaviors can increase nursing students' intentions toward COVID-19 patients. Finally, infection management education programs and research on interventions for nursing students are necessary to enhance the quality of nursing care provided to patients with novel infectious diseases.

Importance of Hospital Infection Control

The increasing demand for healthcare-acquired infection (HAI) control practices and services has intensified the need to evaluate care quality. The World Health Organization (WHO) introduced an infection prevention and control (IPC) framework to mitigate the impact of HAIs, crucial for ensuring patient safety in hospitals. HAIs acquired after hospitalization pose significant challenges due to factors such as compromised immunity, invasive medical procedures, and antibiotic-resistant pathogens, which have dire consequences, including higher mortality rates and increased healthcare costs. Healthcare workers (HCWs) are critical in implementing IPC measures. Infection control programs that include strategies such as hand hygiene, personal protective equipment (PPE), environmental cleaning, and surveillance have become standard. However, challenges such as resistance to change, resource limitations, patient turnover, and variability in patient conditions persist. Strategies to maintain hospital infection control involve rigorous compliance monitoring, staff education, advanced technologies such as artificial intelligence (AI), machine learning (ML), telemedicine, and innovative sanitation methods. The future of hospital infection control may involve increased integration of environmental monitoring, antimicrobial stewardship, and patient participation while leveraging collaboration among healthcare facilities. The review highlights the criticality of hospital infection control and suggests trends and opportunities to strengthen prevention efforts and patient safety.