abstract: 'Background: Healthcare facilities in low-and middle-income countries,

  including the Philippines, face substantial challenges in achieving

  effective infection control. Early stages of interventions should

  include efforts to understand perceptions held by healthcare workers who

  participate in infection control programs.

  Methods: We performed a qualitative study to examine facilitators and

  barriers to infection control at an 800-bed, private, tertiary hospital

  in Manila, Philippines. Semi-structured interviews were conducted with

  22 nurses, physicians, and clinical pharmacists using a guide based on

  the Systems Engineering Initiative for Patient Safety (SEIPS). Major

  facilitators and barriers to infection control were reported for each

  SEIPS factor: person, organization, tasks, physical environment, and

  technology and tools.

  Results: Primary facilitators included a robust, long-standing infection

  control committee, a dedicated infection control nursing staff, and

  innovative electronic hand hygiene surveillance technology. Barriers

  included suboptimal dissemination of hand hygiene compliance data, high

  nursing turnover, clinical time constraints, and resource limitations

  that restricted equipment purchasing.

  Conclusions: The identified facilitators and barriers may be used to

  prioritize possible opportunities for infection control interventions. A

  systems engineering approach is useful for conducting a comprehensive

  work system analysis, and maximizing resources to overcome known

  barriers to infection control in heavily resource-constrained settings.'
affiliation: 'Safdar, N (Corresponding Author), Univ Wisconsin, Dept Med, Div Infect
  Dis, Madison, WI 53705 USA.

  Safdar, N (Corresponding Author), William S Middleton Mem Vet Adm Med Ctr, Madison,
  WI 53705 USA.

  Safdar, N (Corresponding Author), Univ Wisconsin, Infect Control Dept, 5221 Med
  Fdn Centennial Bldg,1685 Highland Ave, Madison, WI 53705 USA.

  Mitchell, Kaitlin F.; Barker, Anna K., Univ Wisconsin, Dept Populat Hlth Sci, Madison,
  WI 53705 USA.

  Mitchell, Kaitlin F.; Barker, Anna K.; Safdar, Nasia, Univ Wisconsin, Dept Med,
  Div Infect Dis, Madison, WI 53705 USA.

  Abad, Cybele L., Med City, Dept Med, Div Infect Dis, Pasig, Philippines.

  Safdar, Nasia, William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53705 USA.

  Safdar, Nasia, Univ Wisconsin, Infect Control Dept, 5221 Med Fdn Centennial Bldg,1685
  Highland Ave, Madison, WI 53705 USA.'
article-number: '90'
author: Mitchell, Kaitlin F. and Barker, Anna K. and Abad, Cybele L. and Safdar, Nasia
author-email: ns2@medicine.wisc.edu
author_list:
- family: Mitchell
  given: Kaitlin F.
- family: Barker
  given: Anna K.
- family: Abad
  given: Cybele L.
- family: Safdar
  given: Nasia
da: '2023-09-28'
doi: 10.1186/s13756-017-0248-2
files: []
issn: 2047-2994
journal: ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL
keywords: 'Systems Engineering Initiative for Patient Safety; Philippines;

  Infection control; Hand hygiene; Intervention implementation'
keywords-plus: 'INTENSIVE-CARE UNITS; HAND HYGIENE; COLLABORATION; PRESCRIPTION;

  IMPROVEMENT; PREVENTION; DOCTORS; IMPACT; SAFETY; ADULT'
language: English
month: SEP 2
number-of-cited-references: '33'
papis_id: 6a67cf24c94ccecc702187ace7f5172a
ref: Mitchell2017infectioncontrol
times-cited: '9'
title: 'Infection control at an urban hospital in Manila, Philippines: a systems engineering
  assessment of barriers and facilitators'
type: Article
unique-id: WOS:000409054800001
usage-count-last-180-days: '1'
usage-count-since-2013: '18'
volume: '6'
web-of-science-categories: 'Public, Environmental \& Occupational Health; Infectious
  Diseases;

  Microbiology; Pharmacology \& Pharmacy'
year: '2017'