Abstract title: Understanding factors influencing paediatric nurses compliance with standard precautions: a qualitative study
Author name: Murad A. Sawalha
Contact details: m.a.sawalha@2011.hull.ac.uk
, murad_80@yahoo.com
, Mobile: 07522286094
Word count: 398

BACKGROUND
Healthcare associated infections (HCAIs) are globally problematic in hospital environments worldwide, resulting in increased patient morbidity and mortality. Healthcare professionals play a vital role in prevention and control of HCAIs by adhering to evidenced based Standard
Precautions Guidelines (SPGs). However, evidence of non-compliance of SPGs remains and negatively impact on paediatric patients by: increasing their hospital stay; infection complications; and increased treatment costs.
STUDY PURPOSE
This study is designed to aid understanding of how nursing children affects nurses' decisions regarding compliance or non-compliance of SPGs. It clarifies paediatric nurses understanding of factors affecting compliance and identifies their perceptions of how to increase compliance.
METHODS
This study uses a qualitative pragmatic design to address a real practice issue, as according to
Avis (2003) it concentrates upon the validity and truth of the arguments.
Additionally employing this design enables the researcher to use ideas from different methods such as phenomenology and grounded theory to address research questions (Jolly, 2013).
The study was conducted in five Jordanian hospitals (one teaching hospital, two public hospitals and two private hospitals) over a three month period and employed purposive sampling of 31 qualified paediatric nurses working in paediatric departments (Wards and Intensive Care Units).
Ethical approval was obtained from the University of Hull; the Jordanian Ministry of Health; and each participating hospital. The data collection method consisted of face to face semi-structured interviews which were audio-taped. Data were transcribed verbatim, coded using Nvivo 10 software, and analysed through constant comparatives. Data were kept anonymous and confidential.
RESULTS
Barriers and facilitators to compliance with standard precautions were identified by qualified paediatric nurses, with some backed up from peer reviewed literature. The main factors acting as

barriers to compliance with standard precautions included: workload and inadequate staffing; negligence and poor ethics; conflicting policies; lack of equipment; knowledge deficit; emergency situations; building structure and poor management. The facilitators included: motivation; protection and safety; religious beliefs; cooperation and communication; monitoring and reminder systems. Practitioners highlighted that nursing children impacted positively and negatively on infection control practice.
DISCUSSIONS AND CONCLUSION
In general nurses thought that compliance rate is suboptimal in paediatric departments, but better than in other hospital departments. Healthcare associated infections and suboptimal compliance with precautions was viewed as a global problem. Hospital administrators and policy makers should develop effective strategies and policies to improve infection prevention and control programmes to find solutions and support compliance facilitators.