Purpose – The purpose of this study is to explore hospital managers’ experiences and reflections concerning the influence of working conditions on nursing staff’s infection prevention behaviours and strategies used by the managers to promote infection prevention work among staff. Design/methodology/approach – The qualitative study uses a reflexive thematic analysis. Six first-line and five second-line managers at surgical and orthopaedic hospital units were interviewed. Findings – Reflecting a balance between resources and responsibility in promoting infection prevention behaviours, four themes were generated: (1) being attentive to staff needs and taking action in a changing healthcare environment, where managers adjust working conditions to minimise interruptions and manage workload; (2) bultivating a positive work climate for both the team and the individual, emphasising team collaboration and role modelling in infection prevention; (3) providing resources for knowledge development and understanding, including appointing hygiene representatives and promoting accessible infection control information; and (4) promoting personal responsibility for compliance and infection-safe workflows, highlighting staff responsibility regardless of working conditions. Originality/value – This study provides new insights into hospital managers’ perspectives on how working conditions influence nursing staff’s infection prevention behaviours and the strategies managers use to support compliance. Unlike prior research focused on frontline staff, this reflexive thematic analysis highlights the managers’ role in balancing organisational support with staff accountability, offering valuable insights into infection control in complex healthcare environments.