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Title: Involving patients in understanding hospital infection control using visual methods
Contributor(s): Wyer, Mary (author); Jackson, Debra  (author); Iedema, Rick (author); Hor, Su-Yin (author); Gilbert, Gwendolyn L (author); Jorm, Christine (author); Hooker, Claire (author); O'Sullivan, Matthew Vincent Neil (author); Carroll, Katherine (author)
Publication Date: 2015
DOI: 10.1111/jocn.12779
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Abstract: 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 frontline 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.
Publication Type: Journal Article
Source of Publication: Journal of Clinical Nursing, 24(11-12), p. 1718-1729
Publisher: Wiley-Blackwell Publishing Ltd
Place of Publication: West Sussex, United Kingdom
ISSN: 0962-1067
Field of Research (FOR): 111099 Nursing not elsewhere classified
Socio-Economic Objective (SEO): 920210 Nursing
Peer Reviewed: Yes
HERDC Category Description: C1 Refereed Article in a Scholarly Journal
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