Background Nurses’ infection prevention and control (IPC) practices influence infection transmission, and their observations of others’ practices may be associated with their own compliance with standard precautions. This study aimed to describe nurses’ IPC observations and standard precautions compliance, examine their relationship, and identify associated characteristics. Methods This descriptive cross-sectional study included 335 nurses from four clinical departments of a city hospital (November 2025–March 2026). Data were collected using the Nurses’ Infection Prevention and Control Observation Questionnaire (NIPCOQ; higher scores indicate more frequent observation of poor practices) and the Compliance with Standard Precautions Scale (CSPS-T) and analyzed using non-parametric tests and multiple linear regression with robust standard errors. Results Mean NIPCOQ and CSPS-T scores were 27.56 ± 9.89 and 14.16 ± 3.40, respectively, and were moderately and inversely correlated ( ρ = −0.323, P < .001). Working in intensive care (vs surgery; B = −3.30, 95% CI −6.49 to −0.58) was associated with less frequent, and 6–10 years of experience (vs 0–5; B = 3.21, 95% CI 0.28 to 6.31) with more frequent, observation of poor practices. High school and associate degree graduates reported higher compliance than bachelor’s degree holders. Each model explained about 5% of the variance. Discussion Nurses who less frequently observed poor IPC practices reported better compliance, although the direction of this association cannot be determined. Individual characteristics explained little variation; organizational factors such as workload, staffing, and safety culture should be examined in multicenter studies.
Background Water, sanitation and hygiene (WASH) services underpin infection prevention and control (IPC), yet gaps persist across Pakistan, and outcomes of comprehensive WASH-IPC delivery in rural facilities are poorly documented. This study assessed facility readiness and patient-reported experience following a bundled, climate-resilient WASH-IPC intervention. Methods An uncontrolled pre-post study was conducted at Rural Health Centre Nindo, Badin, Sindh. The intervention, comprising WASH infrastructure, waste management, IPC consumables, staff training and governance, was delivered during next 1 year. Readiness was scored at baseline and endline using the WHO/UNICEF Water and Sanitation for Health Facility Improvement Tool (WASH-FIT) across seven domains and classified against Joint Monitoring Programme (JMP) service ladders. At endline, external enumerators applied a 32-indicator observation checklist and surveyed 200 patients and companions. Change was expressed as percentage-point difference, and domains were compared using the Wilcoxon signed-rank test. Results The WASH-FIT score rose from 32.3 to 86.9%, with improvement in all seven domains (median gain 62.5 percentage points; p = .016). Gains were greatest for sanitation (16.7% to 100%), hand hygiene (10.0% to 90.0%) and waste management (28.1 to 93.8%). Water quality compliance rose from none to full after ultra-filtration plant installation, and the facility advanced three JMP ladders. All 32 observation indicators were met. Mean satisfaction was 4.29/5 for WASH facilities, 4.17/5 for IPC and 4.37/5 overall; all respondents would recommend the facility. Conclusion Facility readiness improved substantially. The uncontrolled design precludes attribution; the absence of a facility-level WASH budget, backup water source and complete cleaning systems threatens sustainability.
Background Urinary catheters (UC) significantly increase the workload for community nursing services and are a major burden for health care associated infections. Referrals often lack information about why UC are required. In 2023, a community nursing team found 21% of their patients had UC with the clinical indication unknown for at least 44%. This improvement project aimed to reduce the number of inappropriate UC on a community nursing teams’ caseload by enabling the assessment of patients and removing any identified as inappropriate. Methods The model for improvement was used to understand the factors contributing towards the problem, and identify and implement changes to address them. Interventions included awareness and staff training on the use of a decision support checklist (HOUDINI), creation of UC champions and multidisciplinary support group. Changes were tested using plan-do-study-act cycles. Success was measured by auditing how many inappropriate UC were identified and removed, and questionnaires to assess staff knowledge and confidence. Results 43/83 UC were assessed during the study period, 51% (22/43) were identified as inappropriate and successfully removed. This reduced the UC caseload by 24% in 3 months. Strategies to embed the assessment and removal processes are being implemented. Discussion The community nursing team have improved their knowledge about UC and their confidence in decision making to removing them. They now rapidly assess newly referred patients and remove those without appropriate indications. The removal of unnecessary UC improves the quality of patient care and reduces the risk of catheter-associated urinary tract infections.
Background The use of long peripheral catheters (LPCs) and midline catheters (MCs) in pediatric patients is increasing, although evidence regarding their safety and complications remains limited. Objective To describe complications associated with LPCs and MCs in pediatric patients and identify predictors of catheter failure. Methods A prospective observational study was conducted between July 2022 and March 2025 in pediatric patients (17 days–16 years) requiring LPC or MC insertion by nursing staff in a tertiary hospital. Demographic, clinical, catheter-related, and outcome variables were collected. Catheter failure was defined as non-elective removal before completion of planned intravenous therapy. Associations were analyzed using Mann–Whitney U, Fisher’s exact, or χ 2 tests. Results Sixty-nine catheters were included. Overall, 69.6% remained in place until completion of therapy, with a mean dwell time of 11.9 days (SD 7.97). The complication rate was 25.6 per 1000 catheter-days. Thrombosis was the most frequent complication (8.7%; 7.3 per 1000 catheter-days). Difficult venous access was significantly associated with catheter failure (p = 0.044), whereas no significant associations with thrombosis were identified. According to NAVIGATE nomenclature, catheters with axillary or subclavian tip locations were classified as MCs and those with more distal tips as LPCs. Conclusions LPCs and MCs allowed completion of intravenous therapy in most pediatric patients. Thrombosis was the most clinically relevant complication. Larger studies are needed to identify predictors of catheter failure and thrombosis.
Background This study aimed to assess awareness of infectious disease risks and preventive behaviours among adults presenting to emergency departments with suspected infectious diseases. Methods This multicenter descriptive cross-sectional study was conducted between February and March 2026 in four university-affiliated emergency departments in Istanbul. Data were collected through face-to-face interviews with 250 adults using the Patient Information Form and the Communicable Diseases Risk Awareness and Protection Scale. Mann–Whitney U and Kruskal–Wallis tests, Spearman’s rank correlation analysis, and effect-size estimates were used. Results and Discussion The mean CDRAPS total score was 143.01 ± 14.47 (median, 144; range, 85–180). Significant differences in CDRAPS total scores were observed according to mode of arrival, HPV vaccination, smoking, alcohol use, healthcare work reported as an epidemiological risk factor, and isolation type (all p < 0.05); effect sizes for these comparisons were small. Fatigue, pain, fever, and cough were the most common presenting complaints. These findings indicate variation in infectious disease risk awareness and protective behaviours according to selected behavioural, healthcare-related, and infection-control characteristics. Conclusion Infectious disease risk awareness and protective behaviours among emergency department patients varied according to selected behavioural, healthcare-related, and infection-control characteristics. These findings may inform the development and evaluation of patient-centred infection prevention and risk communication strategies integrated into routine emergency care.
