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ORIGINAL RESEARCH article

Front. Public Health

Sec. Infectious Diseases: Epidemiology and Prevention

Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1668493

Association between infection prevention and control (IPC) safety culture and healthcare workers' compliance with infection control measures: A cross-sectional study

Provisionally accepted
Yisui  CenYisui Cen1Chuyu  LaoChuyu Lao2Zihuan  LiZihuan Li3Huiwen  ZhaoHuiwen Zhao4Tian  WangTian Wang3Cuiqiong  FanCuiqiong Fan3Baohong  LiuBaohong Liu3Zhenyao  ZhaoZhenyao Zhao5Ya  ZouYa Zou3Guanwen  LinGuanwen Lin3*
  • 1Department of Infection Prevention and Control, Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, China
  • 2The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
  • 3Guangdong Second Provincial General Hospital, Guangzhou, China
  • 4Shenzhen People's Hospital, Shenzhen, China
  • 5Hong Kong Metropolitan University, Hong Kong, Hong Kong, SAR China

The final, formatted version of the article will be published soon.

Background: Infection prevention and control (IPC) safety culture is recognized as a crucial factor in improving healthcare workers’ (HCWs) compliance with IPC measures. Despite its importance, evidence regarding the influence of IPC safety culture on compliance remains limited and warrants further investigation. Methods: A cross-sectional study was conducted from March 27 to April 3, 2025, using an online questionnaire to examine the association between IPC safety culture and HCWs’ compliance with IPC measures across more than 200 healthcare institutions, including 12 tertiary hospitals. Results: A total of 1,600 questionnaires were distributed, of which 1,471 were valid (91.94%). HCWs aged over 30 years, with more than 5 years of work experience, and holding a Master’s degree or higher had higher IPC safety culture scores compared with their counterparts (p < 0.05). Similarly, HCWs aged over 30 years, with more than 5 years of experience, a Master’s degree or higher, and possessing clinical teaching qualifications demonstrated higher compliance with IPC measures compared with their counterparts (p < 0.05). Linear correlation analysis showed that basic IPC competence was strongly correlated with all dimensions of IPC compliance (r = 0.70, 0.63, 0.62, 0.63, 0.64, and 0.58, p < 0.001). Hospital management climate, departmental team cooperation, organizational learning and continuous improvement, and reporting frequency of hospital-acquired infections (HAIs) adverse events were weakly to moderately correlated with IPC compliance (p < 0.001). Based on a median score of 4.95 (IQR 4.77-5.00), 840 participants (57.10%) were classified as having good compliance, and 631 (42.90%) as poor compliance. Multivariate logistic regression indicated that clinical instructor status (OR = 1.60, 95% CI: 1.46–1.79), basic IPC competence (OR = 1.87, 95% CI: 1.73–1.99), hospital management climate (OR = 1.50, 95% CI: 1.08–2.10), reporting frequency of HAIs adverse events (OR = 1.36, 95% CI: 1.19–1.54), and organizational learning and continuous improvement (OR = 3.59, 95% CI: 2.68–4.80) as independent predictors of IPC compliance. Conclusions: IPC safety culture significantly affects HCWs’ adherence to IPC measures. Enhancing basic IPC competence, hospital management support, organizational learning, reporting practices, and targeted interventions for clinical instructors can improve compliance and help prevent HAIs.

Keywords: Infection Control, Patient Safety, Healthcare worker, Surveys and questionnaires, hospital safety climate

Received: 18 Jul 2025; Accepted: 06 Oct 2025.

Copyright: © 2025 Cen, Lao, Li, Zhao, Wang, Fan, Liu, Zhao, Zou and Lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Guanwen Lin, 1774269636@qq.com

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