‘We are short-staffed’: Dialysis practitioners’ infection prevention and control adherence challenges in the City of Tshwane, South Africa

Abstract

Background: The burden of infections in dialysis facilities continues to rise worldwide. Due to the invasive procedures associated with haemodialysis (HD), patients undergoing HD in dialysis facilities are at high risk of acquiring bloodstream-related infections. Objective: The present study explored the practices of dialysis practitioners regarding the prevention of HD bloodstream-related infections at selected dialysis facilities in the City of Tshwane, Gauteng province, in South Africa. Methods: An exploratory-descriptive contextual qualitative study was conducted in five dialysis facilities utilising semi-structured interviews. Purposive sampling was conducted until data saturation was reached from 10 in-depth semi-structured interviews conducted with dialysis practitioners. Results: Data analysis was conducted concurrently with data collection using a qualitative thematic analysis approach, whereby Tesch’s eight-step method was used to analyse the data. One theme, infection prevention challenges of dialysis practitioners, emerged with three subthemes: (1) in-service training, (2) shortage of resources and (3) colleagues’ behaviors and practices. Conclusion: A lack of staffing, training and resources hinders the implementation of infection prevention and control (IPC) to ensure optimal care in dialysis facilities. These findings suggest that enhancing training programmes and promoting a culture of compliance with IPC protocols are crucial for improving patient safety and outcomes in dialysis settings. Contribution: This study highlights contextual insights into the infection prevention challenges faced by dialysis practitioners in South African dialysis facilities, highlighting critical gaps in training, resources and staff compliance that inform targeted interventions to reduce bloodstream infections.