Nurses’ perceptions of dirt and contagion: Does the work environment pose a greater threat than one’s own home?

Abstract

The aim of this study was to understand nurses’ infection prevention behaviours in the acute hospital setting by eliciting their explanations of observed behaviour. It sought to identify perceptions of risk from infection within their work environment and their homes, the practices carried out to avoid these risks, and the factors that influence behaviour. Twenty semi-structured interviews, using a topic guide and vignettes, were conducted with Registered Nurses. Interviews were audio recorded and transcribed verbatim. Three main themes of ‘Rationalising dirt related behaviour’, ‘Protection from dirt’ and ‘Transitions and journeys: no place like home’ emerged following data analysis using a framework method. This paper presents the theme ‘Transitions and journeys: no place like home’, which has two components: ‘Where is the dirt?’ and ‘Practice and rituals’. The findings demonstrate that dirt and germs present in hospitals represent a higher risk than those in the home. Healthcare workers can take measures to mitigate this risk; however, on leaving the workplace perception of self does not change significantly until they arrive home. At this point a transition occurs; they now recognise the risk they may pose and practices and rituals are required in order to protect the home. The findings demonstrate the multifaceted nature of infection prevention beliefs and behaviours. Behaviour is influenced by knowledge, belief systems and the circumstances of the situation. People see themselves positioned differently within the environment depending on the context of the risk; they can either be at risk or be the cause of the risk.