Structure, Staffing, and Factors Influencing Infection Control Nurses: Findings From an IPCAF-Based Survey and Delphi Consensus Study in Hospitals
7 affiliations
- 1Department of Community Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka India
- 2Faculty of Management, SRM Institute of Science and Technology, Tiruchirappalli Campus, Tiruchirappalli, Tamil Nadu, India
- 3Department of Medical Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India
- 4Department of Health Technology and Informatics, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
- 5Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
- 6Health Systems & Implementation Research, ICMR, New Delhi, India
- 7Adjunct Faculty, College of Health Sciences, VinUniversity, Hanoi, Vietam
Abstract
Introduction: Infection prevention and control (IPC) is a fundamental framework for reducing healthcare-associated infections (HCAIs) and strengthening health system performance and patient safety (Sustainable Development Goal (SDG) 3), particularly in developing countries. However, it is often challenged by poor infrastructure, staff turnover, and low compliance with infection control practices. Hence, this study assesses infection control nurse (ICN) staffing, the factors influencing ICN performance, and facility-level IPC practices.
Method: A two-phase multimethod study was conducted across 27 public and 9 private hospitals in Karnataka, India. Phase one employed an exploratory, onsite survey using a validated questionnaire administered to 49 ICNs (private: n=21; public n = 28) and the Infection Prevention and Control Assessment Framework (IPCAF) tool. Hospitals were categorized as having inadequate, basic, intermediate, or advanced IPC levels on the basis of IPCAF scores. In phase two, a four-round Delphi technique involving 11 ICNs from private hospitals was used to explore the barriers and enablers influencing ICN performance.
Results: All surveyed private hospitals (100%) have ICNs and functional infection control committees (ICCs). Approximately 78% (n=7) of private hospitals fall under advanced IPC levels. In contrast, only two public hospitals had certified ICNs, and 90% reported poorly functioning IPC committees. Among subdistrict public hospitals, 38% were at the basic level, and the remaining 62% were under the intermediate level. Key performance barriers included high workload (private: 85%; public: 56%), inadequate staffing (private: 54%; public: 44%), poor infrastructure (public: 50%), and lack of leadership support (private: 61%; public: 60%). In addition, the Delphi analysis identified major barriers and enablers to improve ICNs’ performance.
Conclusion: The study reported substantial disparities in IPC readiness and ICN capacity across private and public hospitals. Health policy makers should focus on strengthening ICN staffing, training, authority, and surveillance across sub-district hospitals which is critical for enhancing IPC performance.
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BibTeX
@article{sugunan2026structure,
title = {{Structure, Staffing, and Factors Influencing Infection Control Nurses: Findings From an IPCAF-Based Survey and Delphi Consensus Study in Hospitals}},
author = {Aswin Sugunan and Shalini Ganesh Nayak and Vani Lakshmi and Chiranjay Mukhopadhyay and Bontha V. Babu and Anil Raj Assariparambil},
journal = {SAGE Open Nursing},
year = {2026},
month = sep,
doi = {10.1177/23779608261475897},
url = {https://doi.org/10.1177/23779608261475897},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Structure, Staffing, and Factors Influencing Infection Control Nurses: Findings From an IPCAF-Based Survey and Delphi Consensus Study in Hospitals
AU - Aswin Sugunan
AU - Shalini Ganesh Nayak
AU - Vani Lakshmi
AU - Chiranjay Mukhopadhyay
AU - Bontha V. Babu
AU - Anil Raj Assariparambil
PY - 2026
DA - 2026/09/19
JO - SAGE Open Nursing
DO - 10.1177/23779608261475897
UR - https://doi.org/10.1177/23779608261475897
AB - Introduction: Infection prevention and control (IPC) is a fundamental framework for reducing healthcare-associated infections (HCAIs) and strengthening health system performance and patient safety (Sustainable Development Goal (SDG) 3), particularly in developing countries. However, it is often challenged by poor infrastructure, staff turnover, and low compliance with infection control practices. Hence, this study assesses infection control nurse (ICN) staffing, the factors influencing ICN performance, and facility-level IPC practices. Method: A two-phase multimethod study was conducted across 27 public and 9 private hospitals in Karnataka, India. Phase one employed an exploratory, onsite survey using a validated questionnaire administered to 49 ICNs (private: n=21; public n = 28) and the Infection Prevention and Control Assessment Framework (IPCAF) tool. Hospitals were categorized as having inadequate, basic, intermediate, or advanced IPC levels on the basis of IPCAF scores. In phase two, a four-round Delphi technique involving 11 ICNs from private hospitals was used to explore the barriers and enablers influencing ICN performance. Results: All surveyed private hospitals (100%) have ICNs and functional infection control committees (ICCs). Approximately 78% (n=7) of private hospitals fall under advanced IPC levels. In contrast, only two public hospitals had certified ICNs, and 90% reported poorly functioning IPC committees. Among subdistrict public hospitals, 38% were at the basic level, and the remaining 62% were under the intermediate level. Key performance barriers included high workload (private: 85%; public: 56%), inadequate staffing (private: 54%; public: 44%), poor infrastructure (public: 50%), and lack of leadership support (private: 61%; public: 60%). In addition, the Delphi analysis identified major barriers and enablers to improve ICNs’ performance. Conclusion: The study reported substantial disparities in IPC readiness and ICN capacity across private and public hospitals. Health policy makers should focus on strengthening ICN staffing, training, authority, and surveillance across sub-district hospitals which is critical for enhancing IPC performance.
SN - 2377-9608
ER -