FACTORS INFLUENCING CLINICAL NURSES' COMPLIANCE WITH INFECTION CONTROL PRACTICES AT RESOURCE-SCARCE TERTIARY CARE HOSPITAL

Abstract

Background: Healthcare-associated infections (HAIs) are a sizable threat to patient and healthcare workers wellbeing alike in low- and middle-income countries (LMICs), compounded by the rise of multidrug-resistant organisms (MDROs). Nurses’ compliance with infection prevention and control (IPC) practices is crucial but influenced by multiple factors. Aim: This study aimed to evaluate clinical nurses’ compliance with IPC practices and predict factors associated with compliance in a large tertiary care hospital in Swat, Pakistan. Methods: A descriptive cross-sectional study was conducted among 89 registered nurses at Saidu Group of Teaching Hospitals in 2025. Data were collected using validated tools assessing knowledge, attitude, perceived safe environment, and compliance with IPC practices. Descriptive statistics, Pearson’s correlation, and multiple regression analysis were applied using SPSS v22. Results: Participants demonstrated high overall compliance with IPC practices (M = 3.83, SD = .32), with the highest compliance in contaminated materials control (M = 4.14, SD = 2.21) and the greatest variability in MDRO control. Knowledge of standard precautions correlated positively with contaminated material control (r = 0.27, p = .010) and total compliance (r = 0.26, p = .015). Perceived safe environment showed significant positive associations with protective equipment use (r = 0.29, p = .005), MDRO control (r = 0.28, p = .008), and total compliance (r = 0.32, p = .002). Multiple regression analysis revealed perceived safe environment as the strongest predictor of compliance (β = .31, p = .004). Attitude and MDRO-related knowledge did not significantly predict compliance. Conclusion: Nurses in this setting demonstrated generally good compliance with IPC practices; however, compliance with MDRO-related practices was inconsistent, largely due to systemic and resource-related constrains. Organizational support and a safe working environment emerged as more influential than knowledge or attitudes alone. Strengthening institutional resources, leadership support, and continuous education are essential for improving IPC compliance and combating HAIs in resource-limited settings.