Barriers and facilitators to infection prevention and control practices at King Faisal Hospital, Kigali, Rwanda

Objective: To identify barriers and facilitators of infection prevention and control (IPC) practices at King Faisal Hospital (KFH) in Kigali, Rwanda, using the Systems Engineering Initiative for Patient Safety (SEIPS) model. Design: Qualitative study involving semi-structured interviews. Setting: King Faisal Hospital, a tertiary healthcare facility in Kigali, Rwanda. Participants: A purposive sample of 25 hospital staff members from various roles involved in infection control practices. Methods: Semi-structured interviews were conducted, guided by the SEIPS framework which includes domains of person, environment, tasks, organization, tools, and process. Interviews were transcribed, coded, and analyzed to identify recurring themes related to IPC barriers and facilitators. Results: Key barriers included overcrowding, lack of isolation rooms, and significant staff-related factors, such as new staff attitudes, infrequent training, and inconsistent monitoring. Facilitators of IPC practices included adequate availability of hand sanitizer, soap, water, and personal protective equipment, as well as strong IPC policies from hospital administration. A systemic barrier identified was consumer access to antibiotics without a prescription, raising concerns about inappropriate use and antibiotic resistance. Conclusions: To enhance IPC practices, interventions such as increased IPC training and monitoring are recommended. Long-term solutions may include hospital expansion and isolation room creation for each unit. Additionally, legislative action limiting consumer access to antibiotics without a physician’s prescription could mitigate antibiotic resistance at the community and hospital levels.