Abstract
Background: Nurses’ adherence to coronavirus disease 2019 (COVID-19) policies significantly
impacts infection rates, yet various factors, including communication gaps, lack of policy
involvement and insufficient training, hinder compliance.
Objectives: This study investigated the availability of COVID-19 infection control policies and
frontline nurses’ adherence to these policies at an academic hospital in Johannesburg.
Method: A quantitative, descriptive-comparative design was employed, using stratified
random sampling across three phases: policy document analysis, adherence assessment and
observation. Phase one evaluated the comprehensiveness of policies from National Institute
for Communicable Diseases (NICD), Department of Health (DoH) (SA), National Institutes of
Health (NIH) and Centers ffor Disease Control and Prevention (CDC).
Results: National Institute for Communicable Diseases, DoH and academic hospital policies
were 100% adequate, while CDC and NIH policies met 82% of assessed attributes. Phases two
and three assessed adherence using questionnaires and observations. Results revealed higher
adherence during direct patient contact (median 5/7; 70%) compared to pre- and post-contact
behaviours (median 3/6; 50%). Principal component analysis showed a strong correlation
(r = 0.903) between adherence and general precautionary measures.
Conclusion: Despite partial compliance, findings highlight a need for enhanced in-service
training and improved communication strategies to promote policy adherence and minimise
infection risks.
Contribution: Recommendations are provided to strengthen nursing practice, education and
policy development, empowering nurses with knowledge and strategies for effective infection
control.