Airborne infection prevention and control implementation: A positive deviant organisational case study of tuberculosis and COVID-19 at a South African rural district hospital.
Glob Public Health
; 19(1): 2382343, 2024 01.
Article
en En
| MEDLINE
| ID: mdl-39058332
ABSTRACT
There are many examples of poor TB infection prevention and control (IPC) implementation in the academic literature, describing a high-risk environment for nosocomial spread of airborne diseases to patients and health workers. We developed a positive deviant organisational case study drawing on Weick's theory of organisational sensemaking. We focused on a district hospital in the rural Eastern Cape, South Africa and used four primary care clinics as comparator sites. We interviewed 18 health workers to understand TB IPC implementation over time. We included follow-up interviews on interactions between TB and COVID-19 IPC. We found that TB IPC implementation at the district hospital was strengthened by continually adapting strategies based on synergistic interventions (e.g. TB triage and staff health services), changes in what value health workers attached to TB IPC and establishing organisational TB IPC norms. The COVID-19 pandemic severely tested organisational resilience and COVID-19 IPC measures competed instead of acted synergistically with TB. Yet there is the opportunity for applying COVID-19 IPC organisational narratives to TB IPC to support its use. Based on this positive deviant case we recommend viewing TB IPC implementation as a social process where health workers contribute to how evidence is interpreted and applied.
Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Tuberculosis
/
Estudios de Casos Organizacionales
/
SARS-CoV-2
/
COVID-19
/
Hospitales de Distrito
Límite:
Female
/
Humans
País/Región como asunto:
Africa
Idioma:
En
Revista:
Glob Public Health
Asunto de la revista:
SAUDE PUBLICA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Reino Unido