Brief report: the utilization of influencing tactics for the implementation of infection control policies.

INTRODUCTION In the prevention of nosocomial infection, it is important to understand its epidemiology and pathogenesis. Only then are we able to formulate appropriate preventive methods for the various types of infection. However, in recent years there has been growing recognition that the implementation of preventive measures is often only possible when behavioral change occurs.1 In fact, an appreciation of behavioral change principles is critical for infection control nurses (ICNs) because most preventable nosocomial infections are related to inappropriate patient care practices.2 Procedures for prevention are often simple (e.g., washing hands), but compliance can be extremely difficult to enforce in the hospital. The pioneers in applying such social psychological principles in the context of infection control were workers in the SENIC (Study in the Efficacy of Nosocomial Infection Control) project.1,3,4 These workers investigated nurses' compliance to infection control recommendations in response to different types of power influence. The classifications of power used in the SENIC study were the six bases of power first described in 1959 by French and Raven5 and included coercive, reward, legitimate, referent, expert and informational. These classifications however, were rationally organized and based on armchair theorizing. As a result, several inherent problems are present. One difficulty is that people often do not exercise influence in ways predicted by a rational classification scheme.6 Another concern is that the bases of powe do not describe the actual influence tactics, but only the resources that a powerholder can exploit to effect influence on the target.' This distinction is important because powerholders with access to similar bases of power may not necessarily use the same influencing tactics. Further discussion on the abov problems can be found elsewhere,8,9 but these difficulties have instigated recent investigato s of power to pursue the methodology of free response and self reporting. The most relevant study for organizational personnel is the investigation by Kipnis, et al. on intraorganizational influencing tact cs.10 In this study, managers were requested to describe actual incidents in which they attempted to change workers' behavior. From these essays, 58 influencing tactics (defined as the actual means used by powerholders to change the behavior of the target persons) were identified. These studies have bee replicated in other countries (United K ngdom and Australia), enhancing the validity of their findings."1 To evaluate the effectiveness of these 58 tactics in