Exploring organizational culture and its association with standard precaution practices among nurses

Organizational culture defines as the “teamwork of members, cohesiveness, and willingness to work, all of which are important factors to the organization” [1]. However, it is important to note that organizational culture is different from organizational climate, another term commonly used in literature to discuss the collection of values, beliefs, and practices of individuals [2]. Whereas organizational climate pertains to the consensus of employees on what constitutes their values and beliefs (aggregate construct), organizational culture pertains to the culture that is promoted and supported by management through role modeling, change strategies, and institutional guidelines and policies (organizational construct) [3].

Organizational culture is not only an enactment of the values, beliefs, attitudes, and practices of nurses but is also a set of norms, expectations, and values to guide how nurses are expected to practice within their environments [4]. organizations have positive, effective, and responsive cultures, nurses have higher levels of intent to stay, better service quality, lower staff turnover, and better organizational effectiveness [5, 6].

Several resources might be allocated to developing an organizational culture that targets the reduction of HAIs and infectious diseases within a particular healthcare environment. However, because minimal evidence supports that enacted organizational cultures can directly affect infection rates, resources, and supplies would have been wasted and inappropriately used [7].

Existing literature suggests that a positive organizational culture—characterized by strong leadership, open communication, and institutional support—enhances compliance with IPC measures [8, 9]. For example, a study conducted in acute care hospitals in the United States found that hospitals with a strong safety culture reported higher compliance with standard precautions [10]. Similarly, Healthcare workers (HCWs) were more likely to follow infection prevention and control (IPC) guidelines when they felt supported by management, had clear communication about IPC, understood the importance of the guidelines, and participated in mandatory training [11]. Another gap in the literature is the lack of studies comparing different healthcare settings, such as public versus private hospitals, in terms of how organizational culture affects standard precaution adherence. A semi-structured interviews with IPC nurses from 12 public hospitals, Key themes identified included affective mood, opportunity cost, intervention coherence, burden, perceived efficacy, self-efficacy, and ethics [12]. However, there is little exploration of how cultural components, such as teamwork and leadership style, differ across these settings and affect adherence to IPC guidelines.

A negative organizational culture has been previously documented to cause adversarial and failing episodes of care such as medication errors, lack of compassion, disease complications, pressure injuries, falls, and higher rates of infection [13]. studies have suggested that organizational culture has a significant positive relationship with infection control practices. A systematic qualitative review of the literature showed that motivational behaviors and positive perceptions of the work environment as part of a culture’s organization increased hand hygiene compliance among healthcare workers [14]. A multisite assessment of organizational culture in seven European hospitals showed that sites with the lowest prevalence of MRSA were hospitals with the highest levels of organizational culture [15]. A descriptive cross-sectional study involving 420 healthcare workers found that staff engagement as a component of organizational culture was significantly and positively correlated with infection prevention attitudes and compliance and that infection acquisition rates were significantly lower in areas where organizational culture promoted better infection control practices [16].

In Jordan, there are limited studies on organizational culture and infection control practices among nurses working in hospital settings. For one, the two variables are rarely analyzed together, with organizational culture most commonly associated with turnover intention [5, 17] and leadership behavior [18]. Saif, explored the types of organizational culture among Jordanian hospitals, and found that organizational cultures most commonly preferred by employees were adhocracies that prioritize working relationships; however, as a management-led organizational construct, the prevailing type of organizational culture was hierarchical [19]. This is the first study that explored the direct link between infection control practices and organizational culture. The aim of study to examined whether a significant relationship exists between organizational culture and infection control practices of Jordanian nurses working in governmental hospital settings.

A total of 172 nurses participated in the study. The mean age of participants was 37 years old (SD = 7 years). The majority of the participants were female (n = 118, 68.6%) while the rest were male (n = 54, 31.4%). the majority were employed at medical-surgical wards (n = 56, 32.6%), The majority of the participants had more than 10 years of experience as a nurse (n = 105, 61.0%). The majority had a length of experience ranging from 2 to 5 years (n = 46, 26.7%). Participants were asked as to whether they received any previous training in infection control with the majority responding they did (n = 124, 72.1%). participants were asked whether their organization had an existing infection control policy with the majority responding that they did (n = 146, 84.9%). Table 1.

Pearson’s r was used to test whether significant differences existed between infection control practices and organizational culture. Results showed a moderately strong, significant positive relationship between infection control practices and organizational culture (r = 0.46, p < 0.000). Nurses with high scores on infection control practices had high scores on organizational culture. Table 2.

As per the knowledge of the researcher and the review of the literature, this is the first study that explored the direct link between infection control practices and organizational culture. The study’s findings underscored that nurses with high compliance to infection control practices also exhibited high scores in organizational culture. This suggests a positive correlation between effective infection control practices and a strong, safety-oriented organizational culture. This correlation brings to the fore the imperative role of hospital administrators in ensuring that the behaviors, attitudes, and activities of nurses and other healthcare professionals encompass the necessary commitment to infection precaution guidelines and practices. This is consistent with the findings of Smiddy et al., highlighting the influence of organizational culture on adherence to infection control practices [14].

These results contribute significantly to the existing body of evidence on the infection control practices of Jordanian nurses, which had previously been explored mainly as a subset of patient safety or nursing competencies. However, this study distinguished infection control as an independent set of activities, adding depth and complexity to our understanding of infection control within nursing practices in the Jordanian context [23, 24].

Furthermore, these findings offer invaluable insights to nurse managers and hospital administrators. By illustrating the strong connection between organizational culture and infection control practices, the study emphasizes that improvements in adherence to infection prevention and control can be significantly facilitated when these practices are deeply embedded in the fabric of the healthcare organization’s culture. This means that infection control must be viewed not as an isolated practice, but as an integral part of the organization’s ethos, attitudes, and behaviors. This perspective aligns with the views of Choi and Kim [25], Lee and Park [26], and Borg et al. [15], who advocate for integrating infection control practices into the very culture of healthcare organizations for optimum results.

From the variables investigated in the study, the link between infection control practices and organizational culture seemed to be the existence of organizational policies since nurses who worked in hospitals with policies had significantly higher scores on infection control practices and organizational culture. However, this result should be validated by formal mediation and moderation analysis; further investigation can also be focused on other variables that facilitate the relationship between infection control practices and organizational culture.

In essence, by emphasizing the correlation between organizational culture and adherence to infection control practices, this study provides a compelling case for an integrated and culture-focused approach to infection control. It underlines the pivotal role of healthcare administrators in shaping a culture that champions safety and quality, fostering an environment that naturally upholds strong infection control practices.

This study has several limitations. First, it utilized a descriptive, non-experimental design, which meant that it could only detect correlation, not causation. Second, the study employed convenience sampling in hospital settings, limiting the generalizability of the findings to nurses and hospitals with similar characteristics. Third, the study relied on self-reported questionnaires, which are subject to recall bias and social desirability bias. Participants may have provided responses that reflect what is socially acceptable rather than their true beliefs or behaviors. Additionally, the organizational culture assessment tool may carry cultural biases, as it was originally developed in a different cultural context and may not fully capture the unique organizational dynamics in Jordan. Finally, the study’s cross-sectional design measured key variables at a single point in time, preventing an understanding of changes over time. Utilizing longitudinal designs to track changes in infection control practices and organizational culture over time. Implementing random sampling techniques to enhance the generalizability of findings.

Infection control precautions and organizational culture are two significant dimensions of clinical nursing practice. The positive, significant relationship between the two variables suggests the need for strategies that will improve compliance with infection precaution guidelines and, in turn, embed infection precaution practices within the organizational culture to ensure that safe, effective, and quality infection prevention and control become a way of life for nurses and other members of the multidisciplinary team. Future research can focus on the exploration of barriers and facilitators on personal and organizational levels that can influence the uptake of infection control practices and the improvement of levels of organizational culture.