BACKGROUND Adherence to infection prevention and control (IPC) is crucial for patient safety, yet the interactions among factors associated with IPC adherence remain poorly understood. This study investigates direct and indirect factors associated with IPC adherence among obstetric health workers in South Ethiopia using a Capability, Opportunity, Motivation, and Behavior (COM-B) informed path analysis. METHODS We conducted a cross-sectional study among obstetric health workers (n = 218) from nine public hospitals in southern Ethiopia in June and July 2025. We conducted descriptive statistics, correlation analysis, hierarchical linear regression, and path analysis with 5000 bootstrap samples. Standardized beta coefficients with bootstrapped confidence intervals and p-values were reported. RESULTS The mean IPC adherence score was 82.37 ± 9.78. In hierarchical regression, the final model explained 38% of the variance (R2 = 0.38). Path analysis showed direct associations of IPC adherence with opportunity (β = 0.51 [95% CI: 0.42, 0.60], p < 0.001) and motivation (β = 0.19 [95% CI: 0.08, 0.30], p < 0.001), while indirect association with perceived importance of resource improvement through opportunity (β = 0.13 [95% CI: 0.07, 0.20], p < 0.001) and opportunity through motivation (β = 0.04 [95% CI: 0.01, 0.07], p = 0.007). CONCLUSION The included variables explained 38% of the variance in IPC adherence. Opportunity and motivation showed significant direct associations, and perceived importance of resource improvement showed a significant indirect association with IPC adherence, underscoring the potential importance of addressing behavioral and system-level determinants. Future longitudinal studies are recommended to inform causal inferences and intervention development.
INTRODUCTION Inappropriate glove use can compromise hand hygiene, facilitate cross-transmission, and increase resource consumption and the environmental impact of healthcare. This review mapped educational interventions aimed at promoting appropriate glove use among healthcare workers, the outcomes assessed, and the implementation strategies employed. METHODS This scoping review was conducted in accordance with established methodological guidance and reported in accordance with PRISMA-ScR. MEDLINE via PubMed, Embase, Scopus, CINAHL, and LILACS were searched. Intervention components were retrospectively classified using the Expert Recommendations for Implementing Change (ERIC) taxonomy. RESULTS The database searches identified 2848 records. Seven studies were included from database searches and one from reference-list searching, yielding eight studies published between 2007 and 2026. Interventions ranged from individual educational activities to multimodal programmes incorporating educational materials, audit and feedback, reminders, and environmental modifications. The most frequently identified ERIC strategy was conduct educational meetings. Outcomes included glove-related knowledge, directly observed glove-use behaviour, combined glove-use and hand hygiene indicators, overall adherence to Standard Precautions, and glove consumption. Improvements in knowledge did not consistently correspond to behavioural change. More recent interventions were associated with reductions in unnecessary glove use, consumption, costs, waste, and carbon emissions. CONCLUSION Interventions remain predominantly education-focused, with limited evidence of sustained behavioural change. Advancing towards glove stewardship requires implementation strategies guided by the determinants of inappropriate glove use and outcomes that distinguish knowledge from behaviour and assess indicated use, non-use when gloves are unnecessary, appropriate changing or removal, and hand hygiene.
Background Healthcare workers remain at high risk of infection when performing personal protective equipment (PPE) donning and doffing, particularly when procedures are executed incorrectly. Despite their importance, assessment methods vary substantially, and few have been evaluated. This review synthesised and examined published hospital-based PPE assessment methods and evaluated their educational utility using van der Vleuten's framework, encompassing validity, reliability, educational impact, acceptability, and cost. Method A structured narrative review was undertaken to capture heterogeneous study designs related to the topic area. Searches across CINAHL, PubMed, Scopus and Google Scholar (February–April 2026) were conducted. Inclusion criteria consisted of empirical studies assessing donning and doffing performance among hospital-based healthcare workers (2014 - 2026). A best-fit framework approach was used to map each assessment method to van der Vleuten's utility framework. Results Twenty-two studies met inclusion criteria, representing five assessment approaches: checklists (n = 15), video review (n = 6), fluorescent marker contamination (n = 7), MS2 bacteriophage (n = 1), and artificial intelligence-assisted (AI) assessment (n = 1). Checklist-based assessment demonstrated the strongest overall utility due to feasibility, low cost, and broad acceptability, though evidence for validity and reliability was limited. Fluorescent markers provided high educational impact through visible contamination feedback but had reduced ecological validity. Video review and bacteriophage methods showed moderate utility, while AI-assisted approaches offered emerging promise. Methodological inconsistencies across studies limited comparability. Conclusion No single optimal method exists for assessing PPE competence in hospital settings. Checklists remain the most feasible option for routine infection-control practice but require stronger validation. Multimodal approaches incorporating real-time contamination-feedback tools may enhance educational impact and overall utility.
Background Prevention of central line-associated bloodstream infection (CLABSI) is a priority in Australian intensive care units (ICUs). However, the epidemiology of CLABSI in non-ICU settings remains inadequately characterised, despite extensive use of central lines beyond the ICU. We aimed to determine CLABSI rates and microbiological aetiology in non-ICU wards and to compare these with corresponding ICU data from Victorian hospitals. Methods CLABSI surveillance was undertaken voluntarily in non-ICU wards by Victorian health services between 2014 and 2025, utilising the Victorian Healthcare Associated Infection Surveillance System (VICNISS) CLABSI surveillance module, capturing CLABSI rates per 1000 central line days (CLD) as well as bloodstream infections related to mucosal barrier injury (MBI-BSI), in accordance with CDC/NHSN criteria. Retrospective analysis was performed to determine rates, pathogens, and antimicrobial susceptibility. Results Sixteen facilities participated in surveillance during the study period. 67 CLABSI events and 66,096 central line days were reported in non-ICU wards (predominantly haematology-oncology), corresponding to a CLABSI rate of 1.01 per 1000 CLD, which was significantly higher than the contemporaneous ICU CLABSI rate of 0.50 per 1000 CLD (IRR 3.13, 95% CI 1.88–5.22, p = 0.000). The most frequent pathogens responsible for non-ICU CLABSI were coagulase-negative Staphylococcus spp., Staphylococcus aureus, and Pseudomonas spp. A large burden of MBI-BSI events (n = 90) were also reported. Conclusions CLABSI rates outside ICU are significantly higher than those reported in ICU settings. A substantial burden of CLABSI and MBI-BSI events were identified in haematology-oncology populations, supporting focused surveillance and infection prevention efforts in these high-risk cohorts.
