Infection Control Performance Related to Emerging Infectious Diseases Among Emergency Department Nurses: An Ecological Systems Theory-Based Cross-Sectional Study.

BACKGROUND

Emergency department (ED) nurses face elevated risks of infection during emerging infectious disease (EID) outbreaks. A multilevel understanding of factors influencing infection control performance is essential for improving safety in these settings.

AIM(S): To examine associations among safety control, communication, perceived patient safety culture, and infection control performance among ED nurses and identify key influencing factors based on ecological systems theory.

METHODS

A cross-sectional descriptive study was conducted. Data were collected in October 2023 from 227 ED nurses at tertiary hospitals in South Korea who had experience caring for patients with confirmed or suspected EIDs. Structured, self-administered online questionnaires were used, and the responses were analyzed using descriptive statistics, t-tests, one-way ANOVA, correlation analysis, and hierarchical regression (SPSS Version 28).

RESULTS

Communication exhibited the strongest association with infection control performance (β = 0.53, p < 0.001), followed by safety control (β = 0.27, p < 0.001) and the availability of negative-pressure isolation rooms with anterooms (3-4) (β = 0.13, p = 0.016). These factors explained 74.0% of the variance in infection control performance (F = 46.83, p < 0.001).

CONCLUSION

Infection control performance among ED nurses was associated with individual, organizational, and environmental factors. Ecological systems theory provided an effective framework for identifying these multilevel influences.

IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should implement comprehensive multilevel strategies addressing safety control at the microsystem, communication at the mesosystem, and infrastructure at the macrosystem to improve infection control performance. This study provides evidence to support targeted interventions in emergency settings.