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Table 1 Representative quotations of themes identified using the SEIPS framework

From: Infection control at an urban hospital in Manila, Philippines: a systems engineering assessment of barriers and facilitators

SEIPS factor Theme Subject position and department Quotation
Person Role of Infection Control Staff 1: Staff Nurse, Infection Control 1: “We’re doing surveillance for infection control… like gathering data for patients who have risk devices. We’re also checking the environment… to make sure that infection control policies are implemented properly.”
2: Staff Nurse, Oncology 2: “The infection control people visit us… they monitor us… they check everything on a daily basis.”
3: Head Nurse, Internal Medicine 3: “[Healthcare workers are] amenable with the infection control rules… because they’re for the patients.”
Communication to improve hand hygiene 4: Resident, Emergency Medicine 4: “It’s the nurses who do the hand hygiene more than the doctors”
5: Resident, Pediatrics 5: “When [the consultants] go in and we follow, we forget to wash too.”
6: Resident, Pediatrics 6: “I think it needs to be a team effort, like a constant reminder… the head nurses talk to you: ‘Doctor, you need to wash your hands’. I think it’s very helpful, you need to do that… But there are some doctors here who don’t really become too friendly with the nurses. They really set the barrier between them.”
Organization Infection Control Policies 7: Staff Nurse, Infection Control 7: “HICEC is divided into committees… the executive committee makes the policies… we also have the nurses and staff from all different departments. Whenever we make a policy we make sure that all of [the representatives] approve.”
8: Resident, first year 8: “It’s part of the infection control committee responsibilities to do regular lectures on hand hygiene.”
9: Head Nurse, Internal Medicine 9: “We can coordinate with HICEC if we have a misunderstanding with the doctors… because we have a set of admitting guidelines for what is allowed in our ward, so sometimes we just have to tell the doctors that. You can also ask HICEC [to do that].”
Laboratory Facilities 10: Attending Physician, Gastroenterology 10: “[The lab] immediately informs us… so that we can treat right away.”
11: Resident, Pediatrics 11: “We try our best to prevent [resistant infections] here… but other doctors in other places, and the lay people, don’t have any idea what antibiotic resistance means.”
Tasks High Patient Volumes 12: Resident, Emergency Medicine 12: “There are times we have to see one patient, just remove the gloves, and move onto the next patient, so there’s no [time for] alcohol in between.”
Training of New Nursing Staff 13: Resident, first year 13: “[Nurses] get their training and then leave after about two to three years.”
14: Head Nurse, Emergency Medicine 14: “We teach them all the standard precautions and diseases that any nurse could encounter.”
Physical Environment Layout and Access to Hand Hygiene Supplies 15: Head Nurse, Internal Medicine 15: “The baby-friendly [obstetrics/gynecology ward] is much better with the hand hygiene because they have their own station there.”
16: Resident, Emergency Medicine 16: “The alcohol rub is more in the station, where the medications are prepared [by the nurses]… so it’s not really that accessible to us.”
17: Resident, Pediatrics 17: “I see some patients get the alcohol and place it in their room… one of the patients actually got the whole alcohol container.”
18: Resident, Emergency Medicine 18: “There are some doctors who bring their own, or at least have it hooked on to them. And then that’s the time when they can do hand rubbing.”
Technology and Tools CCTV Data Reporting 19: Head Nurse, Emergency Medicine 19: “[Each person] is not being reported, the whole emergency department is being reported. It’s not working I think, because when we look at the results they’re not specific.”
20: Resident, Pediatrics 20: “They should call out those who don’t really hand wash, and talk to them directly. Because [the providers] don’t know they’re being monitored, so they think they can get away with it.”
RFID Badges 21: Staff Nurse, Infection Control 21: “Every time the healthcare worker will enter the patient’s room, the ID will alarm if you don’t do hand hygiene.”
Medical Trolleys 22: Head Nurse, Oncology 22: “The problem here is sometimes the nurses have too many things in their arms… [they need somewhere to] place things first while they’re rubbing their hands.”
  1. HICEC hospital infection control executive committee, CCTV closed circuit television, RFID radio frequency identification