Exploring nurses’ self-motivation with infection prevention and control practices at a selected hospital in Limpopo Province, South Africa

Abstract

Healthcare-associated infections (HAIs) remain a major challenge in maternity units, where mothers and newborns are highly vulnerable. Infection Prevention and Control (IPC) practices are crucial for reducing maternal and neonatal morbidity and mortality; however, adherence among nurses is inconsistent. Understanding the factors that influence nurses’ self-motivation in following IPC guidelines is critical for improving compliance and patient safety. This study aimed to explore nurses’ perceptions and experiences of self-motivation and how these relate to their implementation of IPC practices in a maternity unit of a hospital in Limpopo Province, South Africa. Guided by Self-Determination Theory, the research examined intrinsic motivators, such as autonomy, competence, and relatedness, as well as extrinsic influences, including institutional oversight and the fear of blame. A qualitative, exploratory, descriptive, and contextual design was employed. Data were collected through twelve in-depth, semi-structured interviews with nurses se lected via purposive sampling. Reflexive thematic analysis was used to identify pat terns and themes. Findings revealed that while nurses demonstrate an intrinsic commitment to patient safety and professional integrity, systemic barriers, such as resource shortages, inadequate training, and poor policy dissemination, undermine their motivation. Six major themes emerged, highlighting intrinsic and extrinsic driv ers, institutional challenges, psychological impacts, and strategies for adherence. The study recommends contextually relevant interventions that strengthen both in ternal and external motivational ecosystems to enhance IPC compliance. Findings reveal that while nurses display an intrinsic commitment to protecting patients and upholding professional integrity, systemic challenges, including resource shortages, inadequate training, and limited policy awareness, undermine their motivation to do so. Thematic analysis identified six key themes: intrinsic and extrinsic drivers of motivation, institutional barriers, psychological impact, training needs in IPC, and strategic adherence behaviours. The study emphasises the necessity of nurturing both internal and external motiva tional ecosystems to sustain IPC compliance. It recommends that healthcare insti tutions adopt psychologically informed and contextually relevant interventions to en hance nurses’ adherence to IPC.

Mavabyi lama vangiwaka hi ku khathalela rihanyo (HAIs) ma ha ri ntlhontlho lowukulu eka tindzawulo ta vutswedyana, laha vamanana ni tincece va hlaselekaka hi ku olova. Ku sivela ni ku lawula vuvabyi (IPC) i swa nkoka eku hunguteni ka mavabyi ni ku fa ka vamanana ni tincece; kambe, ku landzeleriwa ka yona hi vaon gori a swi endliwi hi ku hetiseka. Ku twisisa swivangelo leswi susumetaka ku tiyimisela ka vaongori ku landzela swiletelo swa IPC i swa nkoka leswaku ku antswisiwa ku landzeleriwa ka swiletelo ni vuhlayiseki bya vavabyi. Nkambisiso lowu a wu ri ni xikongomelo xo kambisisa ndlela leyi vaongori va titwaka ha yona ni mintokoto ya vona malunghana ni ku va susumeteleka ku endla swo karhi ni ndlela leyi sweswo swi fambisanaka ha yona ni ku tirhisiwa ka tindlela ta IPC exibedlhele xa tincece xa le Xifundzheni xa Limpopo, eAfrika Dzonga. Hi ku kongomisiwa hi Self-Determination Theory, ndzavisiso lowu wu kambisise nhlonhlotelo wa le ndzeni, swo fana ni ku tilawula, vuswikoti ni vuxaka, swin'we ni minkucetelo leyi nga le handle, ku katsa ni vulanguteri bya minhlangano ni ku chava ku soriwa. Ku tirhisiwe endlelo ra nkoka, leri kambisisaka, leri hlamuselaka ni leri twisisekaka. Tinhlayo ti hlengeletiwe hi ku tirhisa mimbulavurisano leyi enteke ya 12 leyi hleri weke ya vaongori lava hlawuriweke hi ku tirhisa endlelo ra ku hlawula hi xikongom elo. Nkambisiso wa tinhloko-mhaka wu tirhisiwile ku kumisisa maendlelo na tin hloko-mhaka. Leswi kumiweke swi paluxe leswaku hambileswi vaongori va kombisaka ku tinyi ketela ka xiviri eka vuhlayiseki bya vavabyi ni ku tshembeka entirhweni, swihinga swa mafambiselo, swo fana ni ku kayivela ka switirhisiwa, ku nga leteriwi hi ndlela leyi faneleke ni ku hangalasiwa ka milawu hi ndlela leyi nga hoxeka, swi tsanisa nsusumeto wa vona. Tinhloko-mhaka ta tsevu letikulu ti humelerile, ti kandziyisa swivangelo swa le ndzeni ni swa le handle, mintlhontlho ya le xikolweni, mimbuyelo ya le mintlhavekweni ni maendlelo ya ku landzelela swiletelo. Ndzavisiso lowu wu bumabumela ku nghenelela loku fambisanaka ni xiyimo lexi, loku tiyisaka fambiselo ra le ndzeni ni ra le handle ra nsusumeto leswaku ku antswisiwa ku fambisana ni IPC. Leswi kumiweke swi kombisa leswaku hambileswi vaongori va tiyimiseleke ku sir helela vavabyi ni ku hlayisa vutshembeki entirhweni wa vona, swiphiqo leswi va langutanaka na swona, ku katsa ni ku kayivela ka switirhisiwa, ku nga leteriwi hi ndlela leyi faneleke ni ku ka va nga tivi milawu ya vutshunguri, swi va endla va nga ha swi koti ku endla ntirho lowu. Nkambisiso wa the-matic wu boxe tinhloko-mhaka ta tsevu ta nkoka: swivangelo swa le ndzeni ni swa le handle swa nsusumeto, swihinga swa mavandla, nkucetelo wa swa miehleketo, swilaveko swa vuleteri eka IPC, ni mahanyelo ya ku namarhela eka maendlelo. Ndzavisiso lowu wu tshikelela xilaveko xa ku kurisa mafambiselo ya le ndzeni ni ya le handle ya nsusumeto ku tiyisisa ku landzeleriwa ka IPC. Yi bumabumela leswaku mavandla ya swa rihanyo ma tirhisa tindlela leti sekeriweke eka ntivo-miehleketo ni leti fambisanaka ni swiyimo leswaku vaongori va ta landzelela swiletelo swa IPC.

Gesondheidsorg-geassosieerde infeksies (GSGI's) bly 'n groot uitdaging in kraam eenhede, waar moeders en pasgeborenes hoogs kwesbaar is. Infeksiebeheer- en voorkomingspraktyke (IBP) is noodsaaklik vir die vermindering van moeder en ne onatale morbiditeit en mortaliteit; die nakoming daarvan onder verpleegsters is eg ter inkonsekwent. Om die faktore te verstaan wat verpleegsters se selfmotivering beïnvloed om IBP-riglyne te volg, is van kritieke belang vir die verbetering van nakoming en pasiëntveiligheid. Hierdie studie het ten doel gehad om verpleegsters se persepsies en ervarings van selfmotivering te ondersoek en hoe dit verband hou met hul implementering van IBP-praktyke in 'n kraam-eenheid van 'n hospitaal in Limpopo Provinsie, Suid-Af rika. Die navorsing is gelei deur die Selfbeslissingsteorie en het intrinsieke mo tiveerders soos outonomie, bevoegdheid en verwantskap sowel as ekstrinsieke invloede, insluitend institusionele toesig en die vrees vir blaam, ondersoek. 'n Kwalitatiewe, eksploratiewe, beskrywende en kontekstuele ontwerp is gebruik. Data is ingesamel deur twaalf diepgaande, semi-gestruktureerde onderhoude met verpleegsters wat via doelgerigte steekproefneming gekies is. Refleksiewe temat iese analise is gebruik om patrone en temas te identifiseer. Bevindinge het getoon dat terwyl verpleegsters 'n intrinsieke verbintenis tot pasiëntveiligheid en professionele integriteit toon, sistemiese struikelblokke soos hulpbronne tekorte, onvoldoende opleiding en swak beleidsverspreiding hul mo tivering ondermyn. Ses hoof-temas het na vore gekom, wat intrinsieke en ekstrin sieke drywers, institusionele uitdagings, sielkundige impakte en strategieë vir nakoming beklemtoon. Die studie beveel kontekstueel relevante intervensies aan wat beide interne en eksterne motiverings-ekosisteme versterk om IBP-nakoming te verbeter.