Organisational Culture and Mask-Wearing Practices for Tuberculosis Infection Prevention and Control among Health Care Workers in Primary Care Facilities in the Western Cape, South Africa: A Qualitative Study

<i>Background</i>: Although many healthcare workers (HCWs) are aware of the protective role that mask-wearing has in reducing transmission of tuberculosis (TB) and other airborne diseases, studies on infection prevention and control (IPC) for TB in South Africa indicate that mask-wearing...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Idriss I. Kallon, Alison Swartz, Christopher J. Colvin, Hayley MacGregor, Gimenne Zwama, Anna S. Voce, Alison D. Grant, Karina Kielmann
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	infection prevention and control tuberculosis PPE masks organisational culture South Africa Medicine R
Acceso en línea:	https://doaj.org/article/2d1a1347e81e41ff94caf325c3382250
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:2d1a1347e81e41ff94caf325c3382250
record_format	dspace
spelling	oai:doaj.org-article:2d1a1347e81e41ff94caf325c33822502021-11-25T17:51:23ZOrganisational Culture and Mask-Wearing Practices for Tuberculosis Infection Prevention and Control among Health Care Workers in Primary Care Facilities in the Western Cape, South Africa: A Qualitative Study10.3390/ijerph1822121331660-46011661-7827https://doaj.org/article/2d1a1347e81e41ff94caf325c33822502021-11-01T00:00:00Zhttps://www.mdpi.com/1660-4601/18/22/12133https://doaj.org/toc/1661-7827https://doaj.org/toc/1660-4601<i>Background</i>: Although many healthcare workers (HCWs) are aware of the protective role that mask-wearing has in reducing transmission of tuberculosis (TB) and other airborne diseases, studies on infection prevention and control (IPC) for TB in South Africa indicate that mask-wearing is often poorly implemented. Mask-wearing practices are influenced by aspects of the environment and organisational culture within which HCWs work. <i>Methods</i>: We draw on 23 interviews and four focus group discussions conducted with 44 HCWs in six primary care facilities in the Western Cape Province of South Africa. Three key dimensions of organisational culture were used to guide a thematic analysis of HCWs’ perceptions of masks and mask-wearing practices in the context of TB infection prevention and control. <i>Results</i>: First, HCW accounts address both the physical experience of wearing masks, as well as how mask-wearing is perceived in social interactions, reflecting visual manifestations of organisational culture in clinics. Second, HCWs expressed shared ways of thinking in their normalisation of TB as an inevitable risk that is inherent to their work and their localization of TB risk in specific areas of the clinic. Third, deeper assumptions about mask-wearing as an individual choice rather than a collective responsibility were embedded in power and accountability relationships among HCWs and clinic managers. These features of organisational culture are underpinned by broader systemic shortcomings, including limited availability of masks, poorly enforced protocols, and a general lack of role modelling around mask-wearing. HCW mask-wearing was thus shaped not only by individual knowledge and motivation but also by the embodied social dimensions of mask-wearing, the perceptions that TB risk was normal and localizable, and a shared underlying tendency to assume that mask-wearing, ultimately, was a matter of individual choice and responsibility. <i>Conclusions</i>: Organisational culture has an important, and under-researched, impact on HCW mask-wearing and other PPE and IPC practices. Consistent mask-wearing might become a more routine feature of IPC in health facilities if facility managers more actively promote engagement with TB-IPC guidelines and develop a sense of collective involvement and ownership of TB-IPC in facilities.Idriss I. KallonAlison SwartzChristopher J. ColvinHayley MacGregorGimenne ZwamaAnna S. VoceAlison D. GrantKarina KielmannMDPI AGarticleinfection prevention and controltuberculosisPPEmasksorganisational cultureSouth AfricaMedicineRENInternational Journal of Environmental Research and Public Health, Vol 18, Iss 12133, p 12133 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	infection prevention and control tuberculosis PPE masks organisational culture South Africa Medicine R
spellingShingle	infection prevention and control tuberculosis PPE masks organisational culture South Africa Medicine R Idriss I. Kallon Alison Swartz Christopher J. Colvin Hayley MacGregor Gimenne Zwama Anna S. Voce Alison D. Grant Karina Kielmann Organisational Culture and Mask-Wearing Practices for Tuberculosis Infection Prevention and Control among Health Care Workers in Primary Care Facilities in the Western Cape, South Africa: A Qualitative Study
description	<i>Background</i>: Although many healthcare workers (HCWs) are aware of the protective role that mask-wearing has in reducing transmission of tuberculosis (TB) and other airborne diseases, studies on infection prevention and control (IPC) for TB in South Africa indicate that mask-wearing is often poorly implemented. Mask-wearing practices are influenced by aspects of the environment and organisational culture within which HCWs work. <i>Methods</i>: We draw on 23 interviews and four focus group discussions conducted with 44 HCWs in six primary care facilities in the Western Cape Province of South Africa. Three key dimensions of organisational culture were used to guide a thematic analysis of HCWs’ perceptions of masks and mask-wearing practices in the context of TB infection prevention and control. <i>Results</i>: First, HCW accounts address both the physical experience of wearing masks, as well as how mask-wearing is perceived in social interactions, reflecting visual manifestations of organisational culture in clinics. Second, HCWs expressed shared ways of thinking in their normalisation of TB as an inevitable risk that is inherent to their work and their localization of TB risk in specific areas of the clinic. Third, deeper assumptions about mask-wearing as an individual choice rather than a collective responsibility were embedded in power and accountability relationships among HCWs and clinic managers. These features of organisational culture are underpinned by broader systemic shortcomings, including limited availability of masks, poorly enforced protocols, and a general lack of role modelling around mask-wearing. HCW mask-wearing was thus shaped not only by individual knowledge and motivation but also by the embodied social dimensions of mask-wearing, the perceptions that TB risk was normal and localizable, and a shared underlying tendency to assume that mask-wearing, ultimately, was a matter of individual choice and responsibility. <i>Conclusions</i>: Organisational culture has an important, and under-researched, impact on HCW mask-wearing and other PPE and IPC practices. Consistent mask-wearing might become a more routine feature of IPC in health facilities if facility managers more actively promote engagement with TB-IPC guidelines and develop a sense of collective involvement and ownership of TB-IPC in facilities.
format	article
author	Idriss I. Kallon Alison Swartz Christopher J. Colvin Hayley MacGregor Gimenne Zwama Anna S. Voce Alison D. Grant Karina Kielmann
author_facet	Idriss I. Kallon Alison Swartz Christopher J. Colvin Hayley MacGregor Gimenne Zwama Anna S. Voce Alison D. Grant Karina Kielmann
author_sort	Idriss I. Kallon
title	Organisational Culture and Mask-Wearing Practices for Tuberculosis Infection Prevention and Control among Health Care Workers in Primary Care Facilities in the Western Cape, South Africa: A Qualitative Study
title_short	Organisational Culture and Mask-Wearing Practices for Tuberculosis Infection Prevention and Control among Health Care Workers in Primary Care Facilities in the Western Cape, South Africa: A Qualitative Study
title_full	Organisational Culture and Mask-Wearing Practices for Tuberculosis Infection Prevention and Control among Health Care Workers in Primary Care Facilities in the Western Cape, South Africa: A Qualitative Study
title_fullStr	Organisational Culture and Mask-Wearing Practices for Tuberculosis Infection Prevention and Control among Health Care Workers in Primary Care Facilities in the Western Cape, South Africa: A Qualitative Study
title_full_unstemmed	Organisational Culture and Mask-Wearing Practices for Tuberculosis Infection Prevention and Control among Health Care Workers in Primary Care Facilities in the Western Cape, South Africa: A Qualitative Study
title_sort	organisational culture and mask-wearing practices for tuberculosis infection prevention and control among health care workers in primary care facilities in the western cape, south africa: a qualitative study
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/2d1a1347e81e41ff94caf325c3382250
work_keys_str_mv	AT idrissikallon organisationalcultureandmaskwearingpracticesfortuberculosisinfectionpreventionandcontrolamonghealthcareworkersinprimarycarefacilitiesinthewesterncapesouthafricaaqualitativestudy AT alisonswartz organisationalcultureandmaskwearingpracticesfortuberculosisinfectionpreventionandcontrolamonghealthcareworkersinprimarycarefacilitiesinthewesterncapesouthafricaaqualitativestudy AT christopherjcolvin organisationalcultureandmaskwearingpracticesfortuberculosisinfectionpreventionandcontrolamonghealthcareworkersinprimarycarefacilitiesinthewesterncapesouthafricaaqualitativestudy AT hayleymacgregor organisationalcultureandmaskwearingpracticesfortuberculosisinfectionpreventionandcontrolamonghealthcareworkersinprimarycarefacilitiesinthewesterncapesouthafricaaqualitativestudy AT gimennezwama organisationalcultureandmaskwearingpracticesfortuberculosisinfectionpreventionandcontrolamonghealthcareworkersinprimarycarefacilitiesinthewesterncapesouthafricaaqualitativestudy AT annasvoce organisationalcultureandmaskwearingpracticesfortuberculosisinfectionpreventionandcontrolamonghealthcareworkersinprimarycarefacilitiesinthewesterncapesouthafricaaqualitativestudy AT alisondgrant organisationalcultureandmaskwearingpracticesfortuberculosisinfectionpreventionandcontrolamonghealthcareworkersinprimarycarefacilitiesinthewesterncapesouthafricaaqualitativestudy AT karinakielmann organisationalcultureandmaskwearingpracticesfortuberculosisinfectionpreventionandcontrolamonghealthcareworkersinprimarycarefacilitiesinthewesterncapesouthafricaaqualitativestudy
_version_	1718411912416329728

Organisational Culture and Mask-Wearing Practices for Tuberculosis Infection Prevention and Control among Health Care Workers in Primary Care Facilities in the Western Cape, South Africa: A Qualitative Study

Ejemplares similares