Epidemiology: Open Access
Open Access

Abstract

During large community outbreaks healthcare workers (HCWs) are integral to the treatment and infection control process.
We have learnt from the sudden acute respiratory syndrome (SAR) and the current Ebola virus outbreak that HCWs
occupationally acquired outbreak infections even when infection prevention equipment is available. Why is this? Modeling
factors associated with behavior change is complex. Our model identified the influence of knowledge, attitudes, effort, social
normative behavior within our community and pressure from peers on compliance with basic infection prevention practices.
Using the model in a low resourced healthcare setting we identified similar barriers predictive of non-compliance. To assist
HCWs to comply with basic infection prevention protocols, programs worldwide have attempted to address most of the
predictive influences for non-compliant behavior. HCWs more aware of infection prevention policies and practices, they know
when and how to hand hygiene, their perception about the effort to comply has been removed by providing alcohol based hand
rub at point-of-care, social norms about hand hygiene are slowly changing, and they understand that their peers expect them
to comply and assist hospitals to be accredited for infection control standards. With these barriers addressed HCWs should
be complying at 100% of the time for the most basic infection control practice - hand hygiene. Yet, when we overtly audit
HCWs’ compliance they never reach 100%! So what is missing? I will present work we are undertaking to address systems
failures within a healthcare system, how we are addressing co-operation of clinical teams and replace outdated views about role
modeling to tip behavior change and save HCWs’ and patients’ lives.

Biography