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Nurs Health Sci. 2016 Sep;18(3):275-82. doi: 10.1111/nhs.12260. Epub 2015 Dec 28.

Enhancing adherence to infection control in Swedish community care: Factors of importance.

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Department of Health Care Science, Ersta Sköndal University College, Stockholm, Sweden.
School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
The Red Cross University College, Stockholm, Sweden.
Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
School of Health and Medical Science, Örebro University, Örebro, Sweden.


Healthcare-associated infections are the most frequent adverse event in healthcare delivery worldwide. The theory of planned behavior has proven helpful in hospital hygiene interventions and might be useful in community care. This study explored how medically-responsible nurses in Swedish community care perceived and ranked the impact of factors related to the theory of planned behavior, the factors" probability to change, enhancing the healthcare staff's adherence to infection control guidelines, and identified which theory of planned behavior subquestions should be focused on to enhance adherence to infection control. Medically-responsible nurses (n = 268) in Swedish communities answered a Web-based questionnaire regarding impact and probability to change theory of planned behavior factors in relation to infection control. Four theory of planned behavior factor constructs were found: (i) knowledge and encouragement from management; (ii) access and availability to materials and equipment, and interest among staff; (iii) influence by colleagues; and (iv) workload, and influence by patients and significant others. The theory of planned behavior factors are relevant for infection control in a home-like environment, and findings could be used as a basis for interventions enhancing hygiene in community care.


adverse events community care; infection control; nursing; theory of planned behavior

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