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Involving patients in understanding hospital infection control using visual methods


Wyer, M and Jackson, D and Iedema, R and Hor, S-Y and Gilbert, GL and Jorm, C and Hooker, C and O'Sullivan, MVN and Carroll, K, Involving patients in understanding hospital infection control using visual methods, Journal of Clinical Nursing, 24, (11-12) pp. 1718-1729. ISSN 0962-1067 (2015) [Refereed Article]

Copyright Statement

2015 John Wiley & Sons Ltd

DOI: doi:10.1111/jocn.12779


Aims and Objectives: This paper explores patients' perspectives on infection prevention and control.

Background: Healthcare-associated infections are the most frequent adverse event experienced by patients. Reduction strategies have predominantly addressed front-line clinicians' practices; patients' roles have been less explored.

Design: Video-reflexive ethnography.

Methods: Fieldwork undertaken at a large metropolitan hospital in Australia involved 300 hours of ethnographic observations, including 11 hours of video footage. This paper focuses on eight occasions, where video footage was shown back to patients in one-on-one reflexive sessions.

Findings: Viewing and discussing video footage of clinical care enabled patients to become articulate about infection risks, and to identify their own roles in reducing transmission. Barriers to detailed understandings of preventative practices and their roles included lack of conversation between patients and clinicians about infection prevention and control, and being ignored or contradicted when challenging perceived suboptimal practice. It became evident that to compensate for clinicians' lack of engagement around infection control, participants had developed a range of strategies, of variable effectiveness, to protect themselves and others. Finally, the reflexive process engendered closer scrutiny and a more critical attitude to infection control that increased patients' sense of agency.

Conclusion: This study found that patients actively contribute to their own safety. Their success, however, depends on the quality of patient-provider relationships and conversations. Rather than treating patients as passive recipients of infection control practices, clinicians can support and engage with patients' contributions towards achieving safer care.

Relevance to clinical practice: This study suggests that if clinicians seek to reduce infection rates, they must start to consider patients as active contributors to infection control. Clinicians can engage patients in conversations about practices and pay attention to patient feedback about infection risk. This will broaden clinicians' understandings of infection control risks and behaviours, and assist them to support appropriate patient self-care behaviour.

Item Details

Item Type:Refereed Article
Keywords:healthcare-associated infection, infection prevention and control, methicillin-resistant Staphylococcus aureus, patient involvement, qualitative research, video-reflexive ethnography
Research Division:Health Sciences
Research Group:Health services and systems
Research Field:Health services and systems not elsewhere classified
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Wyer, M (Ms Mary Wyer)
UTAS Author:Iedema, R (Professor Rick Iedema)
UTAS Author:Hor, S-Y (Dr Su-Yin Hor)
ID Code:100756
Year Published:2015
Funding Support:National Health and Medical Research Council (1009178)
Web of Science® Times Cited:27
Deposited By:Health Sciences
Deposited On:2015-05-27
Last Modified:2017-11-03

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