# Managers and Hygiene Representatives' Perceptions of a Patient Safety Initiative to Reduce Healthcare‐Associated Infections: A Mixed‐Methods Study

## TL;DR

This study explores how managers and hygiene representatives perceive efforts to reduce healthcare-associated infections and improve patient safety through a mixed-methods approach.

## Contribution

The study provides new insights into the organizational and interpersonal factors influencing the implementation of patient safety initiatives.

## Key findings

- Both internal and external organizational factors influenced the implementation process and interactions within the organization.
- A systematic implementation approach and reliable measurements are recommended for creating a patient safety culture.
- Dedicated facilitators who foster collaboration and address prevailing behaviors are crucial for successful patient safety interventions.

## Abstract

More knowledge about perceptions of implementing new ways of working to prevent organism transmission and create safety engagement in health care are needed. This study aimed to explore managers and hygiene representatives', in the role as facilitators, perceptions of safety engagement and factors of importance when implementing measures to reduce healthcare‐associated infections.

Data were collected using both a quantitative and qualitative approach. A total of 24 facilitators were involved in the implementation process (12 managers, and 12 hygiene representatives, all female). The facilitators responded to the Sustainable Safety Engagement Index at three occasions, and 13 of the facilitators participated in open‐ended semi‐structured interviews.

The results displayed that both internal and external organizational factors affected the implementation process as well as the interactions between individuals within the organization. The Sustainable Safety Engagement Index did not indicate any deviations before and during the implementation process.

To create a patient safety culture and get healthcare personnel engaged, it is important for healthcare managers to be aware of the complexity of healthcare and adapt organizational factors and specific elements in the caring chain. A systematic implementation approach, and reliable measurements along with use of single or multiple strategies is recommended. Furthermore, dedicated facilitators who creates an environment of support and cooperation between different professions and provides inspiration is crucial to maintain the improvement work. Prevailing behaviors should also be considered when planning and implementing patient safety interventions.