# Mapping Nurses' Knowledge, Attitudes, and Practices to Guide Competency-Based Infection Control Training

## TL;DR

This study identifies gaps in infection control knowledge and practices among Indian nurses and suggests standardized training to improve patient safety.

## Contribution

The study provides a competency-based framework to guide IPC training by identifying specific knowledge and practice gaps among Indian nurses.

## Key findings

- Nurses showed average competence in knowledge and practice but poor attitudes toward infection control.
- Key gaps were found in device reprocessing, environmental cleaning, and antimicrobial stewardship.
- Practice gaps were linked to resource constraints, workload, and institutional support.

## Abstract

Aim/objective: To assess infection prevention and control (IPC) knowledge, attitudes, and practices (KAP) among Indian nurses and identify key competency gaps to inform standardized training.

Background: Healthcare-associated infections (HAIs) are a persistent global challenge, posing serious risks to patient safety and health system performance. Nurses, as frontline caregivers, have a critical role in IPC. In India, however, the lack of a nationally standardized IPC competency framework and the resulting disconnect between formal nursing education and real-world clinical practice lead to inconsistent implementation and preventable harm. Integrating evidence-based, context-sensitive IPC standards into nursing curricula and ongoing professional training is essential to ensure that best global practices are consistently applied and to strengthen patient safety across diverse healthcare settings.

Design and methods: The study was designed as a nationwide cross-sectional survey, involving a structured online questionnaire, validated against WHO and CDC IPC guidelines, that surveyed 547 Indian nurses across diverse hospitals and regions. Knowledge, attitude, and practice (KAP) scores were categorized as low, average, or good. Descriptive statistics, chi-square tests, and ordinal logistic regression were used for analysis.

Results and discussion: The mean KAP score was 33 ± 5.39 out of 60 (54.73%). Attitude emerged as the weakest domain (45.5%), with knowledge (57.4%) and practice (58.6%) showing average competence. While nurses were confident in standard precautions and transmission chains, many lacked awareness of device reprocessing, environmental cleaning, PPE use, and elements of antimicrobial stewardship. Practice gaps, particularly in hand hygiene and waste management, were identified and appear driven by resource constraints, high patient workloads, and insufficient institutional support. Differences in performance related to experience and workplace setting highlight the critical influence of training quality, exposure, and organizational factors.

Conclusion: This study reveals significant IPC competency gaps among Indian nurses, driven not just by knowledge deficits but by barriers to translating knowledge into daily behaviors. Closing these gaps requires standardized, practical IPC education, targeted certification, and strong institutional mechanisms. The lessons and recommendations from this study, although focused on India, are highly relevant to health systems throughout the global south facing similar challenges in infection control.