TY - CPAPER
AU - KC, Deepti
AU - Ness, Valerie
AU - Smith, J
PY - 2025
DA - July
TI - Experiences of nurses in implementing infection prevention and control guidelines during the COVID-19 pandemic in Nepal and Scotland
EP - 3831
VL - 2
IS - 2, supplement
DO - https://doi.org/10.1016/j.cmicom.2025.105086
AB - Background: The COVID-19 pandemic exposed gaps in infection prevention and control (IPC) programmes across healthcare systems worldwide. This study aimed to identify and compare the factors influencing implementation of IPC guidelines among nurses in Nepal and Scotland during the COVID-19 pandemic using behavioural change frameworks. Methods: This study employed a qualitative design with a cross-national (Nepal and Scotland) comparative approach, guided by the Theoretical Domains Framework (TDF) and the Capability, Opportunity, Motivation-Behaviour (COM-B) model. Online interviews were conducted with 22 registered nurses, 12 from Nepal and 10 from Scotland, in their native languages. Nepali transcripts were translated into English using forward-backward translation. Data were analysed using Reflexive Thematic Analysis, supported by NVivo software. Results: Nurses in both Nepal and Scotland faced common barriers to implementing IPC guidelines, including insufficient IPC skills, inadequate training, redeployment challenges, and knowledge gaps. In Nepal, the absence of national IPC guidelines, reliance on international guidelines, untrained support staff, and poor pandemic management exacerbated these issues. However, online training and hands-on demonstrations helped improve adherence. These factors aligned with TDF domains such as skills, knowledge, memory, attention and decision processes (psychological capability), and environmental context and resources (physical opportunity). Furthermore, limited healthcare infrastructure and resources, including isolation facilities and protective equipment, were common challenges in both countries. Peer support and teamwork facilitated guidelines implementation in both countries, but Nepal’s hierarchical structure often hindered collaboration. Furthermore, Nepal’s weak leadership and organisational climate reduced motivation, whereas nurses in Scotland benefitted from proactive leadership and clear communication. Emotional responses to COVID-19 and burnout also affected nurses’ motivation in both countries. These factors aligned with TDF domains such as social influences (social opportunity), reinforcement and emotions (automatic motivation), and social/professional role and identity (reflexive motivation). Conclusions: This study provided a theoretical understanding of how behavioural, organisational, and environmental factors affected the capability, opportunity, and motivation of nurses in Nepal and Scotland to implement IPC guidelines. These barriers and facilitators can guide the development of evidence-based, context-specific IPC strategies to enhance preparedness for future outbreaks or pandemics.
PB - Elsevier
UR - https://researchonline.gcu.ac.uk/en/publications/c2a83a63-13ea-402c-8213-3a277ac40c13
KW - Coronavirus (COVID-19)
ER