Background: Standard Precautions, particularly the appropriate use of personal protective equipment (PPE), plays a critical role in workplace safety for staff. However, inconsistent applications of Standard Precautions and the widespread availability of non sterile gloves (NSGs) have contributed to substantial overuse. NSGs are frequently used in situations with no risk of blood or body fluid exposure (BBFE) and are often observed to be a substitute for hand hygiene, thereby increasing the potential risk of pathogen transmission.

Design: quality improvement project to test feasibility of an audit on appropriateness of glove use by healthcare workers measured against established standards and protocols.
Methods: A published glove use audit tool was modified from Wilson et al (2015) to reflect glove use behaviours as well as New Zealand healthcare terminology and Hand Hygiene Australia Standards. Over a two-week period in August 2025, two trained hand hygiene auditors covertly observed glove use events during routine care on a 24-bed rehabilitation ward. Data was analysed using descriptive statistics.

Results: 55 glove use events were recorded; 37 (67%) were inappropriate. Inappropriate use was highest among domestic staff (100%) and healthcare assistants (74%), followed by student nurses (62.5%) and registered/enrolled nurses (37.5%).

Conclusion: Findings highlight substantial glove over use and misuse across observed staff groups. The audit tool was confirmed to be suitable for larger scale implementation and will be followed by a wider rollout across the local HNZ district. Findings from this will inform quality improvement initiatives.

References:
Wilson, J., Prieto, J., Singleton, J., O’Connor, V., Lynam, S., & Loveday, H. (2015). The misuse and overuse of non-sterile gloves: application of an audit tool to define the problem. Journal of infection prevention, 16(1), 24-31.

Rationale:
Infection prevention and control (IPC) practices rely heavily on the effective use of disinfectants and cleaning agents to reduce healthcare-associated infections. However, increasing use of these agents can have unintended consequences on medical equipment through material incompatibility and environmental stress cracking (ESC). Damage to surfaces and devices may compromise both patient safety and infection prevention efforts, yet this risk is often under-recognised in clinical practice.

Methodology:
This presentation adopts an educational and evidence-informed approach, outlining the principles of material compatibility and ESC within healthcare environments. It explores the interaction between disinfectant formulations, material composition, and real-world usage conditions. Case-based examples and practical scenarios are used to highlight how routine IPC practices can contribute to material degradation over time.

Significant Results:
Key findings demonstrate that repeated exposure to certain disinfectants, combined with mechanical stress and cleaning practices, can accelerate material failure. This may result in cracking, surface damage, and reduced integrity of medical equipment. Importantly, these effects are often cumulative and not immediately visible, increasing the risk of unnoticed failure and potential infection transmission.

Conclusions:
Material compatibility is a critical but often overlooked component of effective IPC programmes. Balancing effective decontamination with preservation of equipment integrity requires greater awareness, informed product selection, and collaboration between clinical staff, procurement teams, and disinfectant and equipment manufacturers.

Recommendations:
IPC teams should incorporate material compatibility considerations into product selection and policy development, ensure staff education on appropriate product use, and engage with suppliers to understand compatibility data. A proactive, informed approach will support both patient safety and the longevity of healthcare equipment.

Rationale:
Effective decontamination and adherence to transmission-based precautions (TBPs) are essential for preventing healthcare-associated infections. However, variation in practice across healthcare settings can lead to inconsistency, reduced compliance, and increased risk to patients. Standardising decontamination processes using simple, structured approaches may help minimise human factors and improve IPC outcomes.

Methodology:
A structured decontamination protocol, GAR-O (Green–Amber–Red–Outbreak), was developed to align cleaning practices with TBPs, required disinfection levels, and validated disinfectant efficacy. The protocol uses a RAG-rated framework to categorise cleaning requirements based on risk. Visual tools and integration into isolation signage were used to support communication and ease of implementation. Healthcare organisations across Australia, Spain, South Africa, Kuwait, and the UAE were engaged to evaluate feasibility.

Significant Results:
Participating organisations responded positively to the GAR-O framework, reporting that the RAG-rated approach supports clearer understanding of cleaning requirements and improved compliance tracking. Visual cues enabled rapid identification of appropriate actions, enhancing integration with TBPs. Several sites have begun implementing the protocol, demonstrating its practicality across diverse healthcare settings.

Conclusions:
The GAR-O protocol provides a simple, standardised approach to decontamination aligned with international IPC guidelines. By reducing variability and supporting consistent practice, it has the potential to improve compliance and patient safety.

Recommendations:
Healthcare organisations should consider adopting structured, visually supported decontamination frameworks aligned to TBPs. Collaboration between IPC teams and frontline staff will be key to successful implementation and sustained improvement.

Healthcare-associated infections (HAIs) are a leading cause of complications in hospitalised patients, leading to increased morbidity, mortality, and costs to the health system. The World Health Organization highlights that effective infection prevention and control (IPC) measures can significantly reduce HAIs; however, healthcare worker behaviour plays a crucial role. Adherence to IPC protocols is influenced by both individual and system level factors. Aim was to gain insights into factors influencing adherence to IPC protocols and identify innovative interventions to reduce patient harm from HAIs.
This integrative literature review consolidated evidence on behavioural factors affecting healthcare workers' adherence to IPC practices over the past decade. It identified modifiable aspects influencing compliance levels and perceptions of risk, while exploring the motivations behind adherence to essential IPC practices. The review included qualitative, quantitative, and mixed-method studies, which were analysed utilising a validated quality appraisal framework. A total of fifteen articles meeting inclusion criteria and were incorporated into the review.
Key findings included the significant impact of education on healthcare workers' behaviour with its lasting effect dependent on factors such as availability, breadth, and method of delivery. Adherence to IPC protocols was also influenced by beliefs, attitudes, cognitive biases, social influences and resources and organisational support available in the workplace. Notably, patient engagement’s potential as a method to enhance healthcare workers’ compliance with IPC protocols requires further exploration. In addition, while behavioural change frameworks have been proposed to facilitate practice improvement, there are limited implementation studies to date.
Findings from this review provide IPC professionals in Aotearoa New Zealand with insights into the behavioural factors influencing healthcare workers' IPC practices in hospital settings.

Background: Six years ago our NICU found cross transmission of P. aeruginosa, with water from a hand hygiene (HH) sink tap a possible reservoir. Amongst other mitigation strategies, NICU installed bacterial filters on all taps while waiting for all of NICU copper pipe replacement with bespoke monitoring and thermal disinfection (TD) capacity. In 2025 this plumbing work was completed.
New plumbing capacity: Facilities monitors how frequently each HH tap is used. Taps can be programmed to tepid flush if not used after 72 hours. On request, taps can do TD, using a 60-62 degree Celsius water for a duration of 5- 6.5 minutes. Deadlegs were minimised.
Event: In Sept 2025 pseudomonas was found upstream of tap filter in a frequently used HH tap in clinical space. No other taps were contaminated. TD with subsequent water testing indicated the pseudomonas was destroyed.
Discussion: Is thermal disinfection a practical solution for preventing infection in NICU?
• TD does destroy upstream pathogens effectively.
• TD does not destroy pathogens downstream effectively. Sink outlets can be quickly recolonised by pathogens distal to the HH sink. Frequent routine chemical disinfection is the only proven methodology to prevent drain recolonization
• Effective TD schedule relies routine water testing of all HH taps.
• Employ cheap plumbing risk mitigation strategies concurrently, such as routine flushing of infrequently used sinks, protected HH sinks, cleaning, managing hardware risk e.g. aerator replacement, fit for purpose water testing schedule. Consider: reducing number of sinks and deadlegs, choosing risk averse tap and sink hardware, frequent chemical disinfection of HH sink outlets.
Conclusion: Bacterial filters are an expensive long term strategy, but they work. Bespoke plumbing and monitoring is an extremely expensive strategy to set up and ongoing budget to use and maintain.

Hand hygiene is a critical component of Infection Prevention and Control (IPC) in healthcare settings with effective practice known to reduce hospital-acquired infections significantly (1). Despite this knowledge compliance with hand hygiene standards remains a challenge globally, with significantly lower adherence to hand hygiene guidelines in low- and middle-income countries (LMICs) (2). Regional differences in healthcare infrastructure, cultural practices and resource availability are thought to contribute to poor hand hygiene compliance.
This review is part of a larger project which aims to investigate the knowledge, attitudes, and practices of key stakeholders towards hand hygiene and the impact of functional and effective IPC programs on hand hygiene compliance. Understanding these factors will help identify the barriers and facilitators to effective hand hygiene and develop targeted interventions to improve compliance in LMICs.
This initial scoping review was undertaken to examine the published evidence of the World Health Organization 'hand hygiene perception survey for senior managers' and 'hand hygiene perception survey for healthcare workers'. Findings from the review will be used to determine how the perception surveys have been used to elicit and report information relating to the attitudes and perceptions of managers and healthcare workers before deploying these surveys across six Pacific Island Countries and Territories (PICTs) using a cross-sectional convenience sample. The scoping review will be conducted using the Arksey & O'Malley framework and PRISMA-ScR checklist. Key themes will be identified to determine methodologies and methods used in the published literature to shape the use of the hand hygiene perception surveys in the wider research project.

1. Chen Y-C, Sheng W-H, Wang J-T, Chang S-C, Lin H-C, Tien K-L, et al. Effectiveness and Limitations of Hand Hygiene Promotion on Decreasing Healthcare–Associated Infections. PLOS ONE. 2011;6(11): e27163.
2. Global Handwashing Partnership. 2023 Hand Hygiene Research Summary 2023 [Available from: https://globalhandwashing.org/resources/2023-hand-hygiene-researchsummary/

In late 2023 and early 2024, an increase in surgical site infections (SSIs) was observed among patients undergoing spinal and joint replacement surgery. Surveillance data demonstrated that Staphylococcus aureus was the most frequently identified pathogen, accounting for 67% of reported infections. Although preoperative anti-staphylococcal decolonisation is strongly supported by the literature, consistent routine implementation across orthopaedic services had been challenging. This quality improvement initiative aimed to reduce S. aureus-related SSIs through implementation of a standardised preoperative Anti-Staphylococcal Bundle.

A Plan-Do-Study-Act framework was used to introduce a standardised Anti-Staphylococcal Bundle for all spinal and joint replacement procedures. The bundle comprised chlorhexidine skin cleansing and intranasal povidone-iodine administered in three doses within the 24 hours prior to surgery. Implementation was supported through multidisciplinary engagement, development of a patient information pamphlet, and upskilling of a preadmission healthcare assistant to deliver patient education. SSI surveillance data collected from February to April 2024 were compared with post implementation data from March to May 2025.

Prior to implementation, S. aureus accounted for 67% of SSIs. During the post implementation surveillance period, no S. aureus-related SSIs were identified, despite inclusion of a larger surveillance population. Overall SSI rates were lower and consistent with reductions reported in the literature. High compliance with the bundle was achieved across orthopaedic services. Early process issues were identified and addressed, and patient feedback indicated good understanding of, and satisfaction with, the preoperative education provided.

Early surveillance findings demonstrate a reduction in S. aureus-related SSIs following introduction of a standardised preoperative anti-staphylococcal bundle. Ongoing surveillance and longer-term evaluation are recommended to assess sustainability and inform broader implementation, including consideration of other surgical procedures where similar approaches may have the potential to reduce infection risk and strengthen infection prevention and control programmes.

Background:
Complex healthcare is increasingly delivered in homes by community healthcare professionals; infection prevention and control (IPC) must adapt infection surveillance to this environment. Unlike acute inpatient care, community settings often lack structured IPC surveillance, and therefore there is limited visibility of infection risks and outcomes. This creates a gap between IPC practice and the ability to monitor outcomes.
Aim:
To develop and implement an IPC surveillance approach that reflects the realities of home-based care, supports improving practice and meets the requirements of Ngā Paerewa Health and Disability Services Standard NZS 8134:2021. Surveillance aims to improve the consistency and visibility of infection reporting, therefore enabling identification of infections in the community.
Method:
Literature was reviewed to identify suitable community-based surveillance tools. Infections associated with care delivery were prioritised for reporting particularly those involving indwelling devices accessed by staff. Surveillance measures relevant to community care were defined, and standardised documentation and reporting processes were integrated into existing workflows. Surveillance data were combined with staff feedback and observational insights to identify common IPC challenges in home settings. Clear communication was provided to staff regarding reporting expectations, including what to report and how to report it.
Results:
Staff are increasingly identifying and reporting infections through the incident management system. However, several challenges remain, including inconsistent reporting practices, variability in staff knowledge and confidence in identifying infections, and difficulties applying surveillance guidelines within home care settings.
Conclusion:
Delivering IPC “in the wild” require systems that make infection risks visible. Integrating surveillance into community care supports data-informed decision-making and strengthens IPC beyond hospital walls.
Implications for practice:
Community-specific surveillance systems are essential for improving patient safety and embedding sustainable IPC practices across home-based care

Background:
As the complexity and scope of infection prevention and control (IPC) work grows, the professional expectations for those who practice IPC is increasing. Practitioners across Christchurch and the wider South Island (Te Waipounamu) work in diverse settings —acute hospitals, residential care, community services, and private providers, with many working alone and/or in remote settings. Similar challenges are found when implementing IPC programmes, including surveillance, antimicrobial stewardship, and environmental management. There is currently inequity of access to IPC expertise and information across the South Island, especially in the private sector. A collaborative approach would strengthen the IPC capability among these practitioners.
Aim:
To establish a regional IPC network for private organisations that promotes shared learning, best-practice, and collective problem solving across Te Waipounamu.
Objectives:
The objectives of this approach include the following:
• Enable peer to peer learning showcasing local innovations and general problem-solving e.g., projects, outbreaks, environmental challenges, built environment, surveillance insights, occupational health support
• Share resources such as procedures, guidelines, product information, audit tools, and education materials
• Establish mentorship connections linking novice and experienced IPC practitioners
Methods:
The initiative will invite practitioners from private hospitals, residential care, interventional clinics, office-based surgical clinics, primary care, and non-government organisations across Te Waipounamu who may benefit from a collaborative approach. Members will share hosting for regular face-to-face and virtual meetings. The desired outcomes from the collaboration include:
• Improved consistency in IPC programmes across the region
• Shared solutions to challenges
• Strengthened practitioner confidence and capability
• Increased sense of connection to a larger IPC community
• Reduced duplication of effort by aligning resources
• Strengthening the regional IPC voice within the private sector
Conclusion:
Establishing an active IPC network for those working in private practice will result in individual professional development, peer support and improved patient outcomes.

Background:
Surgical site infections (SSI’s) following caesarean sections are significant concern in healthcare. SSIs are common in low- and middle-income countries, estimated one-in-ten people undergoing surgery developing SSI resulting in morbidity, extended hospital stays, increased healthcare costs, or mortality. Study aims to describe SSIs following caesarean section among patients at Vanuatu National Hospital (VNH) enhancing, understanding of SSI incidence, associated risk factors, allow targeted prevention efforts and improved patient outcomes.
Methods:
Prospective descriptive method used, involving analysis patient’s records at VNH from August 2022 to August 2023. Data of c-section cases were collected using SPC- standardized surveillance data tools. SSI is an infection that occurs in the area where surgical procedure was performed. Data collected included patient demographics, co-morbidities occurrence of SSI, timing of SSI and details of antibiotic prophylaxis. Data entered in excel spread sheet and analyzed. SSI incidence calculated as the proportion of all caesarean section cases resulting in SSI.
Results:
270 caesarean sections in the study, total of 31 SSI reported (SSI incidence rate of 11.5%). Among cases, 65% were obese, 16% overweight. Most SSI cases occurred after 8 days, in the first week of post operative. Prophylaxis treatment, 95% comply with antibiotic treatment guideline, 5% not as per guideline.
Conclusion:
This descriptive study provides a comprehensive profile of SSIs following C-sections at VNH over one year period. Findings underscore importance of targeted prevention efforts, enhancing patient care practices. It does not establish casual relationships; it served as a foundation for future research and quality improvement efforts.

Background:
Gloves are a key component of standard precautions in healthcare settings and play an important role in reducing the transmission of microorganisms between healthcare workers and patients. However, inappropriate glove use—including unnecessary use, failure to perform hand hygiene before and after glove use, and prolonged wearing of gloves—can contribute to cross-contamination and reduced compliance with infection prevention and control (IPC) practices. Evidence suggests that overreliance on gloves may create a false sense of security and inadvertently increase infection risks.
Aim:
To examine current practices related to glove use among healthcare workers and promote appropriate, evidence-based glove use to improve infection prevention and patient safety.
Methods:
An observational and educational quality-improvement approach was implemented as a pilot in a medical and surgical wards in 2022. Baseline observations assessed healthcare worker glove use during routine patient care, focusing on indications for glove use, hand hygiene compliance, and glove removal practices. Targeted education, visual reminders, and staff engagement strategies were introduced to reinforce appropriate glove use and hand hygiene practices. Based on the results in 2025, this initiative was implemented in general surgery and ARHOP (Adult Rehabilitation of Older People)
Results:
Initial observations identified several areas for improvement, including unnecessary glove use during low-risk tasks, missed hand hygiene opportunities, and inconsistent glove removal techniques. Following the intervention, improved awareness of glove indications and increased hand hygiene compliance were observed among healthcare workers. Staff feedback indicated that education and visual prompts helped clarify when gloves were required and reinforced the importance of hand hygiene.
Conclusion:
Appropriate glove use is essential for effective infection prevention and control. Education, ongoing monitoring, and reinforcement of evidence-based guidelines can support healthcare workers in using gloves correctly while maintaining optimal hand hygiene practices. Strengthening these practices contributes to reducing healthcare-associated infections and improving patient safety.

Background: Infection prevention and control (IPC) is essential for reducing healthcare-associated infections and ensuring patient and staff safety. Nurses play a central role in implementing IPC practices, yet global evidence shows that adherence remains inconsistent. Literature suggests that nurses’ perceptions of IPC professionals, particularly Infection Prevention and Control Nurses (IPCNs), may influence their willingness to follow IPC protocols. Factors such as trust, respect, communication quality, organisational culture, and misconceptions about the IPCN role shape how nurses interpret and respond to IPC guidance. Despite this, limited research examines how these perceptions translate into compliance behaviours.

Aim: To explore how nurses perceive the role of IPC professionals and examine how these perceptions influence engagement with IPC practices.

Methods: A structured literature review was conducted, analysing research published between 2019 and 2025. Studies were reviewed for themes relating to interprofessional trust, communication, role clarity, organisational influences, and barriers to IPC adherence. Findings were synthesised to identify common patterns and gaps in current evidence.

Results: Nurses’ perceptions of IPC professionals are shaped by interpersonal interactions, IPCN visibility, leadership support, and clarity of role expectations. Misconceptions such as viewing IPCNs as auditors or “germ police” can reduce trust and discourage staff from seeking guidance. Communication barriers and hierarchical dynamics further contribute to disengagement. While many studies describe staff attitudes toward IPC, few investigate how these perceptions influence actual compliance, highlighting a significant gap in the literature.

Conclusion: Nurses’ perceptions of IPC professionals play an important role in shaping IPC engagement, yet the relationship between perception and behaviour remains poorly understood. Strengthening communication, trust, and role clarity, alongside organisational support and consistent IPCN training, may enhance collaboration and improve adherence to IPC practices. Further research is needed to understand how these perceptions are formed and how they influence IPC behaviours in clinical settings.

Problem
Infection prevention and control (IPC) plays a vital role across all areas of healthcare. The recent pandemic highlighted the critical need for New Zealand nurses to possess fundamental IPC skills to ensure healthcare safety at all times.

To bridge this gap, the New Zealand Infection Prevention and Control Nurses College (IPCNC) launched the Fundamentals of IPC Programme in 2020, a concise best practice online course designed to enhance foundational IPC knowledge and skills. Nurses were mentored, as opposed to being supervised and coached. Mentorship is relationship and development focused, supervision is accountability focused, and coaching is performance focused.

Results
Mentorship played a crucial role in enhancing the IPC learning experience and professional development of nurses who came from acute care, aged care, and primary care settings. Experienced IPC mentors provided essential guidance, support, and expertise to 271 mentees as they completed ten self-directed workbooks over four months. The online success rate was 73%. Mentors clarified complex concepts, offered practical insights, and helped apply theoretical knowledge to real-world IPC concerns.

Mentoring in small cohorts facilitated the application of IPC concepts to sector-specific challenges, enhanced collaboration, and provided personalised support that addressed gaps in self-study. Mentorship enabled sustained motivation, accountability, and peer learning.

Conclusion
IPCNC mentors served as role models, sharing their expertise and guiding nurses throughout the course. Graduates have been equipped to competently address ongoing and emerging infection control challenges and have demonstrated significant personal and professional growth.

Lessons learnt
Mentoring in IPC is a strategic tool for professional development, workforce resilience, and in nurturing future IPC experts.