Hygiene risks increase when healthcare staff work together

A new doctoral thesis from the University of Gävle shows that healthcare personnel overestimate their hygiene skills and unknowingly risk contributing to the spread of infection. In addition, the risk of infection spreads when several nurses or nursing assistants assist the same patient.

The number of healthcare-associated infections could be halved if hygiene routines were followed. Despite this, mistakes continue to occur. A new thesis from the University of Gävle challenges the view that stress and understaffing are the main causes.

"My research shows that risky behavior occurs even when healthcare staff perceive the work environment to be good, for example, when there is good cooperation between colleagues. This suggests that it is the healthcare culture and the complexity of the situation that play the biggest role," says Lisa Arvidsson, PhD in healthcare science at the University of Gävle.

Four sub-studies reveal behavioral patterns

In her doctoral thesis, Lisa Arvidsson has conducted observations, interviews, and questionnaire studies with around 500 nursing assistants and nurses in Swedish hospitals. The results show that:

• Healthcare personnel are often unaware of their own mistakes regarding hygiene. A high degree of self-reported compliance with hygiene rules is contradicted by the behaviors observed in the research.
• Collaboration, where several nurses or nursing assistants help with the same patient, leads to more mistakes in hygiene and risks contributing to the spread of infection.

The research shows that more than increased knowledge and resources are needed to reduce the spread of infection, and that it is rather a question of changing the culture in healthcare facilities.

"One positive aspect of the results is that it has been proven that good results can be achieved without necessarily hiring more staff. If you want to increase knowledge about hygiene, I think it is more effective to use practical exercises where you discuss improvements rather than digital training courses where you fill in a test at the end, which is common in healthcare," says Lisa Arvidsson.

New perspective on infection risk

The thesis contributes a new perspective on infection prevention by shifting the focus from individual shortcomings to organizational and cultural patterns in the healthcare environment. The research also provides an understanding of why healthcare-associated infections continue to be a global problem despite significant investments in hygiene in healthcare.

"To successfully prevent the spread of infection, we must also look beyond checklists and training and instead understand how healthcare personnel actually act in complex situations. That is where the real risks arise," says Lisa Arvidsson.