Development and content validation of a risk-stratified nursing intervention programme for the prevention of healthcare-associated infections

Background Healthcare-associated infections (HAIs) remain a major patient-safety challenge, and preventive interventions are rarely tailored to individual infection risk. This study aimed to develop and content-validate a risk-stratified nursing intervention programme for preventing HAIs in hospitalised adults. Methods A methodological Delphi study was conducted with nursing experts in infection prevention and control. An evidence-informed preliminary programme was evaluated for relevance, clarity, appropriateness to risk level and feasibility. Twenty-two experts were invited; 14 participated in round one and 10 in round two. Consensus was assessed using predefined median, interquartile range and agreement criteria. Results The preliminary programme comprised 26 nursing interventions organised by infection risk level. In round one, 18 interventions (69.2%) were retained, seven were revised and one was repositioned as a monitoring strategy. In round two, four revised interventions met all predefined consensus criteria. Routine chlorhexidine use for moderate-risk patients was not retained, whereas conventional body washing and chlorhexidine use for selected high-risk situations were retained following integrated quantitative and qualitative assessment. The final programme integrates universal and risk-specific interventions, periodic risk reassessment, discharge planning, continuity of care and quality monitoring. Conclusions The Delphi process established the content validity of a risk-stratified nursing intervention programme for HAI prevention. The programme provides a structured framework to support nurses in translating infection risk assessment into tailored preventive interventions, reassessment and continuity of care. Feasibility and clinical effectiveness require evaluation in routine practice.