Nosocomial infection in Iranian hospitals: A Mixed-Methods Study

Articles in Press

Document Type : Systematic Review

Authors

1 Master of Health Services Management, Central, Zahedan University of Medical Sciences, Zahedan, Iran

2 zabol university of medical science

3 PhD of nursing, Department of Nursing, School of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran.

4 PhD of Health Services Management, Department of Health Management, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran

10.22038/ebcj.2026.92393.3209

Abstract

Background: Hospital-acquired infections (HAIs) pose a significant threat to patient safety and healthcare efficiency in Iran. This study aimed to determine the overall prevalence of HAIs in Iranian hospitals and identify effective strategies for their mitigation.
Methods: A mixed-methods approach was employed. Initially, a systematic review and meta-analysis were conducted to quantify prevalence of HAIs across Iranian hospitals. Relevant articles were searched in five databases and Google Scholar, with 22 studies meeting the inclusion criteria analyzed using Comprehensive Meta-Analysis software. Subsequently, a modified Delphi method was utilized to gather expert opinions on potential solutions, involving 15 experts from various health sectors
Results: This mixed-methods study examined HAIs in Iran and identified strategies to reduce them. The first phase, a systematic review and meta-analysis of 22 quantitative studies, revealed substantial heterogeneity (I² = 90.33%) and highlighted the significant burden of HAIs. The second phase used a modified two-round Delphi method with 15 experts to determine optimal strategies, assessed using the FAME framework (Feasibility, Appropriateness, Meaningfulness, Effectiveness). 82 strategies were assessed in the first round, and a face-to-face meeting was held in the second round to refine strategies, with consensus defined as >70% agreement. The best strategies were included hand hygiene compliance and its washing; proper ventilation for specialized care; developing a plan for infection control training; sterilization of bed sheets, dressing and other equipment; establishing an infection prevention and control committee
Conclusion: HAIs represent a significant challenge in Iranian hospitals, necessitating comprehensive and targeted intervention strategies.

Keywords

Main Subjects

Evidence Based Care

Articles in Press, Accepted Manuscript
Available Online from 14 June 2026

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