Structure, Staffing, and Factors Influencing Infection Control Nurses: Findings From an IPCAF-Based Survey and Delphi Consensus Study in Hospitals
Year: 2026
Type: article
Study design: Observational Study
Abstract: Introduction: Infection prevention and control (IPC) is a fundamental framework for reducing healthcare-associated infections (HCAIs) and strengthening health system performance and patient safety (Sustainable Development Goal (SDG) 3), particularly in developing countries. However, it is often challenged by poor infrastructure, staff turnover, and low compliance with infection control practices. Hence, this study assesses infection control nurse (ICN) staffing, the factors influencing ICN performance, and facility-level IPC practices. Method: A two-phase multimethod study was conducted across 27 public and 9 private hospitals in Karnataka, India. Phase one employed an exploratory, onsite survey using a validated questionnaire administered to 49 ICNs (private: n=21; public n = 28) and the Infection Prevention and Control Assessment Framework (IPCAF) tool. Hospitals were categorized as having inadequate, basic, intermediate, or advanced IPC levels on the basis of IPCAF scores. In phase two, a four-round Delphi technique involving 11 ICNs from private hospitals was used to explore the barriers and enablers influencing ICN performance. Results: All surveyed private hospitals (100%) have ICNs and functional infection control committees (ICCs). Approximately 78% (n=7) of private hospitals fall under advanced IPC levels. In contrast, only two public hospitals had certified ICNs, and 90% reported poorly functioning IPC committees. Among subdistrict public hospitals, 38% were at the basic level, and the remaining 62% were under the intermediate level. Key performance barriers included high workload (private: 85%; public: 56%), inadequate staffing (private: 54%; public: 44%), poor infrastructure (public: 50%), and lack of leadership support (private: 61%; public: 60%). In addition, the Delphi analysis identified major barriers and enablers to improve ICNs' performance. Conclusion: The study reported substantial disparities in IPC readiness and ICN capacity across private and public hospitals. Health policy makers should focus on strengthening ICN staffing, training, authority, and surveillance across sub-district hospitals which is critical for enhancing IPC performance.
Source: SAGE Open Nursing
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,500
OpenAlex ID: W7213616706