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Abstract

Infection prevention and control (IPC) is a critical component of patient safety in intensive care units (ICUs), where patients are highly vulnerable to healthcare-associated infections. This study aimed to explore the lived experiences, perceptions, and contextual factors influencing IPC adherence among ICU nursing staff. A qualitative descriptive design was employed. Data were collected from ICU nurses using semi-structured interviews, focus group discussions, and document analysis of institutional IPC protocols. Purposive sampling was used to recruit participants from diverse ICU settings. Data were thematically analyzed following Braun and Clarke’s framework, with trustworthiness ensured through credibility, transferability, dependability, and confirmability measures. Four interrelated themes emerged: (1) knowledge and perceptions of infection risks, (2) social and cultural influences on practice, (3) organizational support and resource constraints, and (4) feedback mechanisms and continuous improvement. Findings indicated that adherence to IPC protocols was strongest when individual knowledge, peer support, adequate resources, and constructive feedback aligned. However, lapses occurred during high workload, PPE shortages, or when perceived infection risk was low. Notably, “reactive adherence” and “adaptive non-compliance” were identified as behavioral patterns, reflecting both responsive and pragmatic coping strategies in challenging contexts. IPC adherence in ICUs is a multifactorial process shaped by individual, social, and institutional factors. Sustainable improvement requires integrated strategies combining training, resource provision, peer modeling, and continuous feedback. The insights generated inform theory, policy and practice, contributing to safer ICU environments.