Human factors considerations in designing for infection prevention and control in neonatal care – findings from a pre-design inquiry

Abstract

Qualitative data collection methods drawn from the early stages of human-centred design frameworks combined with thematic analysis were used to develop an understanding of infection prevention practice within an existing neonatal intensive care unit. Findings were used to generate a framework of understanding which in turn helped inform a baseline approach for future research and design development. The study revealed that a lack of clarity between infection transmission zones and a lack of design attributes needed to uphold infection prevention measures may be undermining healthcare workers’ understanding and application of good practice. The issue may be further complicated by well-intentioned behavioural attitudes to meeting work objectives; undue influences from spatial constraints; the influence of inadvertent and excessive touch-based interactions; physical and/or cognitive exertion to maintain transmission barriers; and the impact of expanding job design and increased workload to supplement for lack of effective barriers.

Practitioner Summary: Despite high hand hygiene compliance within a neonatal intensive care unit, healthcare workers expressed concerns about the unit design and infection prevention practice. Early inquiry methods from human-centred design and thematic analysis helped develop a framework to understand how design can be used to aid infection prevention.

Keywords:

• Infection prevention and control
• neonatal intensive care unit
• human factors
• ergonomics
• design

Acknowledgements

Thanks are given to all the staff from the neonatal intensive care unit who participated in this study, Christine Smith, Lucie Charron, Joyce Mackay Perry, Louise Dufort, Barbara Foote, Dr. Stephanie Redpath, Dr. Brigitte Lemyre, Nathalie Bruce, Michele Larocque-Levac, Debra Bournes, Heather McDonald, Ruth Rennicks White and Dr. Kathryn Suh.