RESUMO
BACKGROUND: The intensive care unit (ICU) is considered the epicenter of infections, and patients in the ICU are at higher risk of infection because of their vulnerability, age, and lengthy hospitalization. METHODS: The ethnographic design has been used to describe, examine, and evaluate the policies and procedures that are implemented to prevent and control hospital-acquired infections (HAIs) in the medical ICU in King Abdullah University Hospital. In-depth semi-structured interviews with 23 participants supported by nonparticipant observation and document analysis were carried out to collect triangulated data. The themes and subthemes were developed through a software package and hand-coding procedure. RESULTS: Health care workers were aware but not fully engaged to prevent and control HAIs; nevertheless, they presented themselves as knowledgeable. Staff recognized the importance of involving family members and visitors. However, they had serious concern toward open visitation. The nurse to patient ratio was another challenge of infection prevention and control practices. The findings demonstrated that performing continuous prospective surveillance by highly qualified and trained staff can reduce the risk of endemic HAIs. CONCLUSIONS: The study highlighted the importance of changing behaviors and practices of health care providers and visitors to improve adherence to infection prevention and control policies and practices.