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Jordanian paediatric nurses' views on compliance with Standard Precautions : a qualitative study

Sawalha, Murad Adnan


Murad Adnan Sawalha


Jeremy Jolley

Mary C. Laurenson


Compliance with evidence-based Standard Precautions Guidelines (SPGs) among healthcare practitioners is essential to combat Healthcare Associated Infections (HCAI). However, it is widely understood that non-compliance with these precautions remains a common problem in paediatric nursing practice. Most existing studies into this problem have used quantitative methods. However, these studies have failed to explain noncompliant behaviour or address the issues that are specific to paediatric clinical areas.
This study is designed to investigate paediatric nurses' perceptions and experiences of infection control measures and to achieve a better understanding of the factors that influence nurses’ compliance with SPGs.
This qualitative study used an adapted constructivist grounded theory approach. The study was conducted in five Jordanian hospitals. Thirty one (n=31) qualified paediatric nurses from different paediatric areas were reccruited to the study. Data were gathered using face-to-face semi-structured audio-taped interviews, which were transcribed and coded through constant comparative analysis.
This study identified causes of enduring failure by nurses to comply fully with SPGs. Four themes emerged (Children are different; Nurses are human first; Limited professional status; The challenges of the working environment). Paediatric nurses claim to be willing to comply with SPGs, but sometimes fail to achieve this. Risk of exposure to microorganisms was perceived as a major factor in compliance. Paediatric nursing practice was seen as different to adult practice and nurses construed the need for SPGs differently.
A key issue is the fact that nurses were reluctant to see themselves as change-agents to improve practice. This resulted in problems with SPGs being well understood but not acted on. Nurse’s prioritised compliance with the nursing culture in their specific clinical area, over more general principles of care, such as SPGs. Nurses did appreciate that compliance with SPGs was suboptimal and did sometimes criticise this situation. However, most nurses had a value system, which militated against the proper use of Standard Precautions and which served to diminish the influence of them.
The chief implication of this study is that infection control is unlikely to improve further until nurses feel empowered to initiate change. Nursing in this area of the world is essentially semi-professional in nature. Nursing needs to develop to become fully professional in its orientation so that nurses take full responsibility for their actions. Only when nurses see their actions and behaviour as fully their responsibility, will nursing issues such as this be properly addressed. Until this occurs, the imposition of rules and guidelines, documentation and policies, will not be sufficient to progress care in this important area of practice.


Sawalha, M. A. (2017). Jordanian paediatric nurses' views on compliance with Standard Precautions : a qualitative study. (Thesis). University of Hull. Retrieved from

Thesis Type Thesis
Deposit Date Aug 10, 2018
Publicly Available Date Feb 23, 2023
Keywords Nursing
Public URL
Additional Information School of Health and Social Work, The University of Hull
Award Date May 1, 2017


Thesis (5.8 Mb)

Copyright Statement
© 2017 Sawalha, Murad Adnan. All rights reserved. No part of this publication may be reproduced without the written permission of the copyright holder.

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