Assessing infection control training in ICUs using the Kirkpatrick model: a prospective cohort study

Abstract

Background: Hospital-acquired infections (HAIs) are a significant global health challenge, particularly in intensive care units (ICUs), where patient vulnerability is high. Effective infection prevention and control (IPC) training is critical for reducing HAIs and improving healthcare outcomes. This aims to evaluate the efficacy of an IPC training program via Kirkpatrick’s four-level model. Methods: A prospective cohort study was conducted between June and December 2024 at Shebin El Kom Fever Hospital’s ICU. The study involved 106 healthcare workers (84 nurses, 22 physicians) who participated in a two-month training program combining theoretical lectures and practical sessions. Program effectiveness was assessed via Kirkpatrick’s 4 levels: reaction (satisfaction surveys), learning (knowledge tests), behavior (direct observation), and results (clinical outcomes). Results: Ninety health care workers (HCWs) whose level of satisfaction exceeded 80% across all training aspects (Level 1) were included. The knowledge assessment revealed a significant improvement in the mean test score from 76.93 to 82.29% (p = 0.0112) (Level 2). Behavioral evaluation revealed substantial improvements in infection control practices, particularly in nurses’ aseptic procedures (40.00–83.54%, p < 0.001) and physicians’ personal protective equipment (PPE) usage (19.05–62.50%, p = 0.0391) (Level 3). At Level 4, no significant changes were observed in HAIs, mortality rates, or hospital stay costs. Conclusion: IPC training programs significantly enhance HCW knowledge and compliance with infection control practices, laying the groundwork for sustainable ICU infection control. While immediate improvements in hospital metrics were not observed, long-term monitoring is crucial to achieving full benefits. Enhanced compliance may reduce HAIs and associated costs over time.