@misc{KC_D-0001_210015,
title = {Learning from COVID-19 in Practice to Enhance Infection Prevention and Control Learning for the Future: A Qualitative Cross-National Comparative Study Between Nepal and Scotland},
author = {KC, D.},
month = {jan},
year = {0001},
abstract = {Background: The coronavirus disease (COVID-19) pandemic exposed major gaps in infection prevention and control (IPC) worldwide, even in countries with advanced healthcare systems. Despite IPC guidance from organisations such as the World Health Organization (WHO) and the Centres for Disease Control and Prevention (CDC), COVID-19 transmission still occurred in healthcare settings. Nurses, as the frontline responders of the COVID-19 pandemic, also faced considerable difficulties in adhering to IPC guidance in both low- and middle-income, as well as high-income, countries. However, few studies have explored and compared the IPC practices of nurses in high- and low-income countries during the COVID-19 pandemic.Aim: This PhD study utilised a theory-based approach to explore and compare the experiences of nurses from Nepal and Scotland in adhering to IPC guidelines during the COVID-19 pandemic.Methods: This study used a generic qualitative research design combined with a case oriented, cross-national comparative approach. The Capability, Opportunity, Motivation-Behaviour (COM-B) model and the Theoretical Domains Framework (TDF) were adopted as the theoretical frameworks. Online interviews were conducted with 22 registered nurses, 12 from Nepal and 10 from Scotland, who had worked in acute care settings during the COVID-19 pandemic. Interviews were conducted in participants’ native languages (English and Nepali), with the interviews in Nepali translated into English. Data were analysed using Reflexive Thematic Analysis process, and NVivo 20 software was used for data management and coding. The TDF and the COM-B model were further employed to organise and interpret findings across both countries.Results: This study identified five key themes from Nepal and four from Scotland regarding nurses’ experiences with adhering to IPC guidelines during the COVID-19 pandemic. Nurses in both countries faced similar barriers to adherence, including difficulties in adapting to changing IPC guidance, gaps in knowledge, skills and training, psychosocial challenges, and organisational changes. However, some differences were noted, particularly in infrastructure and leadership styles between the two countries. In relation to the TDF, factors related to 11 of the 14 TDF domains were identified as influencing adherence to IPC guidelines among nurses in Nepal, while factors related to 10 of the 14 domains were identified in Scotland. Additionally, all three components of the COM-B model, Capability (psychological), Opportunity (physical and social), and Motivation (reflexive and automatic), were found to influence adherence to IPC guidelines among nurses in both Nepal and Scotland.Conclusions: This study contributes to new knowledge by providing a theoretical understanding of how various factors at behavioural, organisational, and environmental levels influenced the capability, opportunity, and motivation of nurses in Nepal and Scotland to adhere to IPC guidelines. It particularly highlights the need to develop IPC guidelines tailored to the healthcare needs of each country, to provide training that enhances knowledge and skills for adherence to guidelines, and to strengthen organisational support in terms of both infrastructure and management. This study also emphasises the importance of mental health support for nurses to improve both their capability and motivation to adhere to guidelines. Finally, the study findings offer implications and recommendations for policy, practice, and education to improve adherence to IPC guidelines among nurses.},
journal = {Glasgow Caledonian University},
publisher = {Glasgow Caledonian University},
url = {https://doi.org/10.59019/FSWF9851},
}
