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Jeong H, Lee W, Jang SG, Pyo J, Choi EY, Baek SJ, Ock M. Perception gaps of patient engagement for patient safety between healthcare professionals and the public in Korea. Curr Med Res Opin 2024:1-9. [PMID: 38646669 DOI: 10.1080/03007995.2024.2346334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 04/18/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND To ensure effective patient engagement, patients' efforts, partnerships with healthcare professionals, and the organisation's role in providing safe healthcare settings must be emphasised. Perception gaps regarding patient engagement between the public and healthcare professionals could prevent healthy partnerships from forming and hinder patient engagement activities. This study examined healthcare professionals' perception of patient engagement and compared the findings with that determined for the public in a previous study. METHODS An anonymous online survey was conducted in February 2020 among 1,007 healthcare professionals (physicians, nurses). The questionnaire comprised five parts regarding the perception of patient engagement. Descriptive analysis and Chi-squared/Fisher's exact tests determined the frequency and significant differences among the public from previous study and healthcare professionals in this study. RESULTS The perception of the importance of patient safety was high among healthcare professionals and the public. However, statistically significant differences in perceptions were observed among the public and healthcare professionals in all categories. The perception gaps were substantial between the groups in sub-categories of engagement for patient safety during medical treatment; 86% of physicians and 90% of nurses agreed that patients participate in the decision-making for the treatment process. Conversely, 58% of the public agreed. Only 22% of the public agreed with confirming healthcare professionals' hand washing to prevent infection, versus 57% of physicians and 65% of nurses. More than 89% of healthcare professionals positively perceived medical dispute mediation versus only half of the public. In certain areas such as "medical dispute mediation and arbitration programs", "fall prevention", and "infection prevention", there was a statistically significant difference in the perception of patient involvement among healthcare professionals, with nurses' perception being particularly more positive than that of physicians. CONCLUSIONS The healthcare professionals' perception of patient engagement was more positive than that of the public. To narrow the perception gaps and enhance the public's perception, strategies involving changes in healthcare systems, promotional efforts, and educational initiatives should be developed. Additionally, strategies should be formulated for healthcare professionals to better engage as partners in patient care.
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Affiliation(s)
- Hyeran Jeong
- Task Forces to Support Public Health and Medical Services in Ulsan Metropolitan City, Ulsan, Republic of Korea
- Department of Preventive Medicine, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Won Lee
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | | | - Jeehee Pyo
- Task Forces to Support Public Health and Medical Services in Ulsan Metropolitan City, Ulsan, Republic of Korea
- Department of Preventive Medicine, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Eun Young Choi
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | - Seung Ju Baek
- Department of Nursing, Graduate School of Chung-Ang University, Seoul, Republic of Korea
| | - Minsu Ock
- Task Forces to Support Public Health and Medical Services in Ulsan Metropolitan City, Ulsan, Republic of Korea
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
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Park JY, Pardosi JF, Islam MS, Respati T, Nurhayati E, Charania N, Chowdhury KIA, Seale H. Supporting patients and their carers to participate in infection prevention and control activities: The views of patients, family members, and hospital staff from Bangladesh, Indonesia, and South Korea. Am J Infect Control 2024; 52:200-206. [PMID: 37394183 DOI: 10.1016/j.ajic.2023.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/23/2023] [Accepted: 06/23/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND Hand hygiene reminders for healthcare workers (HCWs) are commonly used to empower patients. However, this approach overlooks the role of family carers in delivering direct contact care in Asian countries. Limited knowledge exists regarding empowerment strategies for patients and their family carers in infection prevention and control (IPC) recommendations. This study aimed to provide a comprehensive exploration of IPC empowerment within the context of family involvement in care provision across Bangladesh, Indonesia, and South Korea. METHODS In-depth interviews were conducted in 5 tertiary-level hospitals in Bangladesh, Indonesia, and South Korea. A total of 64 participants were interviewed through 57 interviews, including 6 group interviews, comprising 2 groups: (1) patients and their family and private carers; and (2) HCWs. RESULTS The study identified barriers to engaging patients and family carers in IPC measures. These included concerns about the patient-HCW hierarchical relationship, lack of knowledge about healthcare-associated infection, IPC, and patient zone, perceptions of IPC as a barrier to family connections, and disempowerment of patients in IPC due to family bonds. CONCLUSIONS This study provides diverse perspectives on IPC empowerment, revealing challenges faced by patients, family carers, and HCWs. The interlaced relationship established by social norms of family carer provision hinders the empowerment of family carers. Acknowledging the cultural influence on health care arrangements and its implication for IPC empowerment is crucial in mitigating these barriers.
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Affiliation(s)
- Ji Yeon Park
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.
| | - Jerico Franciscus Pardosi
- School of Public Health & Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Md Saiful Islam
- Emerging Infections Program, International Centre for Diarrhoeal Disease Research, Bangladesh; Department of Global Health Program, Kirby Institute, UNSW, Sydney, Australia
| | - Titik Respati
- Public Health Department, Faculty of Medicine, Universitas Islam Bandung, Bandung, Indonesia
| | - Eka Nurhayati
- Public Health Department, Faculty of Medicine, Universitas Islam Bandung, Bandung, Indonesia
| | - Nadia Charania
- Department of Public Health, Auckland University of Technology, Auckland, New Zealand
| | | | - Holly Seale
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
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Campbell JI, Pham TT, Le T, Dang TTH, Chandonnet CJ, Truong TH, Duong H, Nguyen DD, Le TH, Tran TH, Nguyen TKO, Ho TMT, Le KN, Pollack TM, Sandora TJ. Facilitators and barriers to a family empowerment strategy to improve healthcare worker hand hygiene in a resource-limited setting. Am J Infect Control 2020; 48:1485-1490. [PMID: 32492500 DOI: 10.1016/j.ajic.2020.05.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 05/20/2020] [Accepted: 05/21/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The World Health Organization recommends empowering patients/families to remind healthcare workers (HCWs) to perform hand hygiene (HH). We sought to understand acceptability of a family empowerment strategy in a Vietnamese pediatric intensive care unit (PICU). METHODS With end-user input, we designed a tool to help families in a PICU in Vietnam to remind HCWs to perform HH. We conducted 3 preliminary focus group discussions (FGDs) with patients' family members (n = 8), physicians (n = 9), and nurses (n = 8) to understand acceptability of preliminary tools, attitudes towards HH and barriers to HH. Tools were then modified and implemented in a 5-week intervention study. We then conducted 3 more FGDs with families (n = 7), physicians (n = 7), and nurses (n = 8). Discussions were analyzed using qualitative directed content analysis. Families who used the tool were asked to complete written surveys. FINDINGS Both family members and HCWs felt that HCWs had a responsibility to perform HH. Barriers to performing HH were identified, including forgetfulness and time constraints. Family members felt shy reminding HCWs to perform HH. However, the HH reminder tool was acceptable, and some felt it could overcome barriers to reminding HCWs to perform HH. HCWs felt embarrassed when reminded to perform HH, but felt that the reminder was useful. Nearly all (99%) survey respondents felt that family members should speak up if they noticed HCWs omitting HH. CONCLUSIONS A tool given to families to remind HCWs to perform HH was largely acceptable in a pediatric ICU in Vietnam. Perceived benefits of improving HH were felt to surmount barriers to tool use.
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Affiliation(s)
- Jeffrey I Campbell
- Division of Infectious Diseases, Department of Pediatrics, Boston Children's Hospital, Boston, MA.
| | - Thanh Thuy Pham
- Department of Medicine, Beth Israel Deaconess Medical Center, and The Partnership for Health Advancement in Vietnam, Hanoi, Vietnam
| | - Trang Le
- Department of Medicine, Beth Israel Deaconess Medical Center, and The Partnership for Health Advancement in Vietnam, Hanoi, Vietnam
| | - Thi Thu Huong Dang
- Department of Infection Prevention and Control, Vietnam National Children's Hospital, Hanoi, Vietnam
| | | | - Thi Hoa Truong
- Department of Cardiology, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Hao Duong
- Department of Medicine, Beth Israel Deaconess Medical Center, and The Partnership for Health Advancement in Vietnam, Hanoi, Vietnam
| | - Duc Duat Nguyen
- Department of Medicine, Beth Israel Deaconess Medical Center, and The Partnership for Health Advancement in Vietnam, Hanoi, Vietnam
| | - Thi Huyen Le
- The Partnership for Health Advancement in Vietnam, Hanoi, Vietnam
| | - Thi Ha Tran
- The Partnership for Health Advancement in Vietnam, Hanoi, Vietnam
| | - Thi Kim Oanh Nguyen
- Department of Infection Prevention and Control, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Thi Minh Than Ho
- Department of Infection Prevention and Control, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Kien Ngai Le
- Department of Infection Prevention and Control, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Todd M Pollack
- Department of Medicine, Beth Israel Deaconess Medical Center, and The Partnership for Health Advancement in Vietnam, Hanoi, Vietnam
| | - Thomas J Sandora
- Division of Infectious Diseases, Department of Pediatrics, Boston Children's Hospital, Boston, MA
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Diedrich S, Görig T, Dittmann K, Kramer A, Heidecke CD, Hübner NO. Active Integration of Patients into Infection Control, as perceived by Health Care Professionals: Results of the AHOI Pilot Study. Infect Drug Resist 2020; 13:4009-4019. [PMID: 33204118 PMCID: PMC7667167 DOI: 10.2147/idr.s261343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 09/11/2020] [Indexed: 11/23/2022] Open
Abstract
Objective Medical professionals have a key role in active patient involvement in infection control and prevention (ICP). ICP of hospital-associated infections is critical for patient safety and requires targeted integration of patients and their relatives. The possibilities of proper involvement are identified, tested and realized in the innovative AHOI project. Its acronym stands for Activation, Help, Open communication and Infection prevention. The project is based on the three dimensions acceptance, empowerment and adherence. The results presented here are from a health-care professional (HCP) focused part of a pilot study to implement AHOI intervention. This section aimed at the HCPs’ evaluation of the intervention material, their perception and acceptance of the adherence and empowerment of patients, as well as the perception of their and colleagues’ own behavior. Methods The cross-sectional survey was conducted with a questionnaire at two surgical wards of a third-level hospital for 14 weeks. All HCPs with contact to patients were entitled to voluntarily participate in the study. AHOI instruments such as visual reminder, videos for patients and the AHOI-box were implemented on the wards. Additionally, the ward personnel received a psychological and practical train-the-trainer curriculum. Results Sixty-nine questionnaires were handed out and 29 returns were analyzed. The results show a strong identification and acceptance of HCPs with their role in the AHOI project. No additional workload was perceived by implementing AHOI. Teaching of medical professionals and information materials are seen as good supports. HCPs are empowering hygienic behavior in patients and colleagues. HCPs observed increasing adherence of patients. Conclusion HCPs positively perceived acceptance, support and identification with the ideas of the AHOI project. Therefore, since HCPs are key for patients and their relatives, AHOI intervention seems to be a feasible instrument and aid in implementing national and international recommendations for hygienic behavior.
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Affiliation(s)
- Stephan Diedrich
- Department of General Surgery, Visceral, Thoracic and Vascular Surgery, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Tillmann Görig
- Central Unit for Infection Prevention and Control, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Kathleen Dittmann
- Central Unit for Infection Prevention and Control, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Axel Kramer
- Institute of Hygiene and Environmental Medicine, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Claus-Dieter Heidecke
- Department of General Surgery, Visceral, Thoracic and Vascular Surgery, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Nils-Olaf Hübner
- Central Unit for Infection Prevention and Control, Universitätsmedizin Greifswald, Greifswald, Germany
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Duhn L, Godfrey C, Medves J. Scoping review of patients' attitudes about their role and behaviours to ensure safe care at the direct care level. Health Expect 2020; 23:979-991. [PMID: 32755019 PMCID: PMC7696111 DOI: 10.1111/hex.13117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 06/10/2020] [Accepted: 07/14/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND To improve harm prevention, patient engagement in safety at the direct care level is advocated. For patient safety to most effectively include patients, it is critical to reflect on existing evidence, to better position future research with implications for education and practice. METHODS As part of a multi-phase study, which included a qualitative descriptive study (Duhn & Medves, 2018), a scoping review about patient engagement in safety was conducted. The objective was to review papers about patients' attitudes and behaviours concerning their involvement in ensuring their safe care. The databases searched included MEDLINE, CINAHL and EMBASE (year ending 2019). RESULTS This review included 35 papers about "Patient Attitudes" and 125 papers about "Patient Behaviours"-indicative of growing global interest in this field. Several patterns emerged from the review, including that most investigators have focused on a particular dimension of harm prevention, such as asking about provider handwashing, and there is less known about patients' opinions about their role in safety generally and how to actualize it in a way that is right for them. While patients may indicate favourable attitudes toward safety involvement generally, intention to act or actual behaviours may be quite different. CONCLUSION This review, given its multi-focus across the continuum of care, is the first of its kind based on existing literature. It provides an important international "mapping" of the initiatives that are underway to engage patients in different elements of safety and their viewpoints, and identifies the gaps that remain.
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Affiliation(s)
- Lenora Duhn
- School of NursingQueen’s UniversityKingstonONCanada
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Mody L, Washer LL, Kaye KS, Gibson K, Saint S, Reyes K, Cassone M, Mantey J, Cao J, Altamimi S, Perri M, Sax H, Chopra V, Zervos M. Multidrug-resistant Organisms in Hospitals: What Is on Patient Hands and in Their Rooms? Clin Infect Dis 2019; 69:1837-1844. [PMID: 30980082 PMCID: PMC6853699 DOI: 10.1093/cid/ciz092] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The impact of healthcare personnel hand contamination in multidrug-resistant organism (MDRO) transmission is important and well studied; however, the role of patient hand contamination needs to be characterized further. METHODS Patients from 2 hospitals in southeast Michigan were recruited within 24 hours of arrival to their room and followed prospectively using microbial surveillance of nares, dominant hand, and 6 high-touch environmental surfaces. Sampling was performed on admission, days 3 and 7, and weekly until discharge. Paired samples of methicillin-resistant Staphylococcus aureus (MRSA) isolated from the patients' hand and room surfaces were evaluated for relatedness using pulsed-field gel electrophoresis and staphylococcal cassette chromosome mec, and Panton-Valentine leukocidin typing. RESULTS A total of 399 patients (mean age, 60.8 years; 49% male) were enrolled and followed for 710 visits. Fourteen percent (n = 56/399) of patients were colonized with an MDRO at baseline; 10% (40/399) had an MDRO on their hands. Twenty-nine percent of rooms harbored an MDRO. Six percent (14/225 patients with at least 2 visits) newly acquired an MDRO on their hands during their stay. New MDRO acquisition in patients occurred at a rate of 24.6/1000 patient-days, and in rooms at a rate of 58.6/1000 patient-days. Typing demonstrated a high correlation between MRSA on patient hands and room surfaces. CONCLUSIONS Our data suggest that patient hand contamination with MDROs is common and correlates with contamination on high-touch room surfaces. Patient hand hygiene protocols should be considered to reduce transmission of pathogens and healthcare-associated infections.
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Affiliation(s)
- Lona Mody
- Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Michigan Medical School, Detroit, Michigan
- Geriatrics Research Education and Clinical Center, Veterans Affairs Ann Arbor Healthcare System, Detroit, Michigan
| | - Laraine L Washer
- Department of Infection Prevention and Epidemiology, Michigan Medicine, Detroit, Michigan
- Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Health System, Detroit, Michigan
| | - Keith S Kaye
- Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Health System, Detroit, Michigan
| | - Kristen Gibson
- Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Michigan Medical School, Detroit, Michigan
| | - Sanjay Saint
- Patient Safety Enhancement Program and Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Detroit, Michigan
- Division of Hospital Medicine, Department of Medicine, University of Michigan Health System, Ann Arbor, Detroit, Michigan
| | - Katherine Reyes
- Division of Infectious Diseases, Henry Ford Health System, Detroit, Michigan
| | - Marco Cassone
- Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Michigan Medical School, Detroit, Michigan
| | - Julia Mantey
- Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Michigan Medical School, Detroit, Michigan
| | - Jie Cao
- Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Michigan Medical School, Detroit, Michigan
| | - Sarah Altamimi
- Division of Infectious Diseases, Henry Ford Health System, Detroit, Michigan
| | - Mary Perri
- Division of Infectious Diseases, Henry Ford Health System, Detroit, Michigan
| | - Hugo Sax
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Vineet Chopra
- Patient Safety Enhancement Program and Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Detroit, Michigan
- Division of Hospital Medicine, Department of Medicine, University of Michigan Health System, Ann Arbor, Detroit, Michigan
| | - Marcus Zervos
- Division of Infectious Diseases, Henry Ford Health System, Detroit, Michigan
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Perceptions and attitudes of patients and health care workers toward patient empowerment in promoting hand hygiene. Am J Infect Control 2019; 47:45-50. [PMID: 30268593 DOI: 10.1016/j.ajic.2018.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 07/02/2018] [Accepted: 07/02/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Patient empowerment is a component of the World Health Organization's multimodal strategy to improve hand hygiene (HH). Its successful implementation requires knowledge of the perceptions and attitudes of patients and health care workers (HCWs) toward patient empowerment in HH. METHODS A cross-sectional study, through a self-administered questionnaire of patients and their families and HCWs, was conducted in a 433-bed block of an 850-bed university hospital in Galicia, Spain. RESULTS A total of 337 patients and their families and 196 HCWs completed the questionnaire. Among patients and their families, 49.9% were willing to remind HCWs about HH. However, only 31.6% of HCWs (41.8% of physicians and 24.8% of nurses) supported patient participation. The most common reason for patients and their families not being willing to ask caregivers to perform HH was fear of causing annoyance or receiving worse treatment as a consequence (76%). The main reasons that physicians disagreed with patient participation was patients' lack of knowledge (40%) and possible negative effects on the HCW/patient relationship (40%). Nurses considered this participation unnecessary (58%). CONCLUSIONS There were significant differences between patients and their families and HCWs regarding support for patient empowerment in promoting HH. In our setting, a cultural change is needed in the HCW/patient relationship to create a facilitating environment.
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Oliveira ACD, Pinto SDA. Patient participation in hand hygiene among health professionals. Rev Bras Enferm 2018; 71:259-264. [PMID: 29412281 DOI: 10.1590/0034-7167-2016-0124] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 04/07/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To investigate the perception and attitude of health professionals (HPs) about the patient participation in hand hygiene (HH). METHOD A cross-sectional study with 150 HPs from a university hospital in Brazil. A descriptive analysis was conducted. RESULTS Simple hand hygiene was the preferred method of HPs, rather than hand rubbing with alcohol-based solutions. A total of 83.3% of the HPs supported the patient participation in reminding them about HH, but 48% reported that they would feel uncomfortable; 45.3%, comfortable; and 20.7% were familiar with the "Patients for Patient Safety" program. CONCLUSION HPs showed limited knowledge about HH, opposing recommendations on the topic. The contradiction between the HPs acceptance and attitude when questioned by the patient regarding HH was revealed, reflecting a lack of knowledge about the WHO program and the need to implement educational practices in health.
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Affiliation(s)
| | - Selma de Almeida Pinto
- Universidade Federal de Minas Gerais, Postgraduate Program in Nursing. Belo Horizonte, Minas Gerais, Brazil
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Alzyood M, Jackson D, Brooke J, Aveyard H. An integrative review exploring the perceptions of patients and healthcare professionals towards patient involvement in promoting hand hygiene compliance in the hospital setting. J Clin Nurs 2018; 27:1329-1345. [PMID: 29423965 DOI: 10.1111/jocn.14305] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2018] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To review patients' and healthcare professionals' perceptions of patient involvement in promoting hand hygiene compliance in the hospital setting. BACKGROUND Initiatives continue to emphasise the importance of involving patients in their safety at the point of care. A patient-centred care approach aimed to empower patients to become active members of the healthcare team. However, understanding the perceptions of patients and healthcare professionals of patient involvement in promoting hand hygiene compliance among healthcare professionals has yet to be fully explored. DESIGN Integrative literature review. METHODS A five-stage review process informed by Whittemore and Knafl's methodology was conducted. MEDLINE and CINAHL were searched for papers published between January 2009-July 2017. Data were extracted manually, organised using NVivo 11 and analysed using thematic analysis. RESULTS From an identified 240 papers, 19 papers were included in this review. Thematic analysis revealed two main themes with three related subthemes. Patients were willing to remind healthcare professionals (especially nurses) to wash their hands, healthcare professionals perception towards patients' involvement varied from one study to another. However, an overall positive attitude towards patient involvement was related to how patients asked and how healthcare professionals responded to being asked. CONCLUSION There is limited evidence regarding patients' actual intention to ask healthcare professionals to wash their hands, and some evidence that patients are reluctant to do so. Further research is required to understand this area thoroughly, including which situations patients would feel more empowered to speak up. RELEVANCE TO CLINICAL PRACTICE Simple messages promoting patient involvement may lead to complex reactions in both patients and healthcare professionals. It is unclear, yet how patients and staff react to such messages in clinical practice. There is a need for a deeper understanding of how they can work together to support harm free care.
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Affiliation(s)
- Mamdooh Alzyood
- Faculty of Health and Life Sciences, Oxford Institute of Nursing, Midwifery, and Allied Health Research (OxINMAHR), Oxford Brookes University, Oxford, UK
| | - Debra Jackson
- Faculty of Health and Life Sciences, Oxford Institute of Nursing, Midwifery, and Allied Health Research (OxINMAHR), Oxford Brookes University, Oxford, UK
| | - Joanne Brooke
- Faculty of Health and Life Sciences, Oxford Institute of Nursing, Midwifery, and Allied Health Research (OxINMAHR), Oxford Brookes University, Oxford, UK
| | - Helen Aveyard
- Faculty of Health and Life Sciences, Oxford Institute of Nursing, Midwifery, and Allied Health Research (OxINMAHR), Oxford Brookes University, Oxford, UK
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Affiliation(s)
- Rachel Schwartz
- VA Palo Alto Health Care System, Center for Innovation to Implementation, Menlo Park, California; .,Center for Health Policy and Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, California
| | - Paul J Sharek
- Division of Hospital Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California and.,Center for Quality and Clinical Effectiveness, Lucile Packard Children's Hospital, Palo Alto, California
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11
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Lastinger A, Gomez K, Manegold E, Khakoo R. Use of a patient empowerment tool for hand hygiene. Am J Infect Control 2017; 45:824-829. [PMID: 28768590 DOI: 10.1016/j.ajic.2017.02.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 02/09/2017] [Accepted: 02/09/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND Patient empowerment is recognized as an important component of a multimodal strategy to improve hand hygiene adherence. We examined the attitudes of adult patients and parents of pediatric patients toward a new patient empowerment tool (PET) at our hospital. We also surveyed physicians to determine their perceptions about the PET. METHODS A cross-sectional survey was performed of hospitalized children's parents and adult patients in a 531-bed tertiary care teaching hospital in West Virginia. Surveys were anonymous and self-administered. A separate survey was administered via e-mail to resident and attending physicians from the departments of internal medicine, pediatrics, and family medicine. RESULTS Most parents and adult patients felt it was their role to speak up if a provider did not perform hand hygiene, but a smaller number actually felt comfortable using the PET. Only 54.9% of physicians felt that patients should be involved in reminding providers to perform hand hygiene. Overall, physicians indicated that they would prefer a patient to use words rather than the PET to remind them to perform hand hygiene. CONCLUSIONS In our study, parents and adult patients supported use of the PET, but physicians were less supportive. As the patient empowerment movement grows, we should work to improve physician acceptance of patient involvement if it is to be successful.
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Affiliation(s)
- Allison Lastinger
- Section of Infectious Diseases, School of Medicine, West Virginia University, Morgantown, WV.
| | - Kayeromi Gomez
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, WV
| | - Ellen Manegold
- Department of Psychology, Eberly College of Arts and Sciences, West Virginia University, Morgantown, WV
| | - Rashida Khakoo
- Section of Infectious Diseases, School of Medicine, West Virginia University, Morgantown, WV
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Kim D, Ahn JY, Lee CH, Jang SJ, Lee H, Yong D, Jeong SH, Lee K. Increasing Resistance to Extended-Spectrum Cephalosporins, Fluoroquinolone, and Carbapenem in Gram-Negative Bacilli and the Emergence of Carbapenem Non-Susceptibility in Klebsiella pneumoniae: Analysis of Korean Antimicrobial Resistance Monitoring System (KARMS) Data From 2013 to 2015. Ann Lab Med 2017; 37:231-239. [PMID: 28224769 PMCID: PMC5339095 DOI: 10.3343/alm.2017.37.3.231] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 09/21/2016] [Accepted: 01/24/2017] [Indexed: 11/23/2022] Open
Abstract
Background National surveillance of antimicrobial resistance becomes more important for the control of antimicrobial resistance and determination of treatment guidelines. We analyzed Korean Antimicrobial Resistance Monitoring System (KARMS) data collected from 2013 to 2015. Methods Of the KARMS participants, 16 secondary or tertiary hospitals consecutively reported antimicrobial resistance rates from 2013 to 2015. Data from duplicate isolates and institutions with fewer than 20 isolates were excluded. To determine the long-term trends, previous KARMS data from 2004 to 2012 were also considered. Results The prevalence of methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus faecium from 2013 to 2015 was 66–72% and 29–31%, respectively. The resistance rates of Escherichia coli to cefotaxime and cefepime gradually increased to 35% and 31%, respectively, and fluoroquinolone resistance reached 48% in 2015. The resistance rates of Klebsiella pneumoniae to cefotaxime, cefepime, and carbapenem were 38–41%, 33–41%, and <0.1–2%, respectively, from 2013 to 2015. The carbapenem susceptibility rates of E. coli and K. pneumoniae decreased from 100% and 99.3% in 2011 to 99.0% and 97.0% in 2015, respectively. The resistance rate of Pseudomonas aeruginosa to carbapenem increased to 35% and the prevalence of carbapenem-resistant Acinetobacter baumannii increased from 77% in 2013 to 85% in 2015. Conclusions Between 2013 and 2015, the resistance rates of E. coli to third- and fourth-generation cephalosporins increased continuously, while carbapenem-susceptibility gradually decreased, particularly in K. pneumoniae. The prevalence of carbapenem-resistant P. aeruginosa and A. baumannii increased significantly; therefore, few treatment options remain for these resistant strains.
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Affiliation(s)
- Dokyun Kim
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Young Ahn
- Department of Laboratory Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Chae Hoon Lee
- Department of Laboratory Medicine, College of Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Sook Jin Jang
- Department of Laboratory Medicine, Chosun University College of Medicine, Gwangju, Korea
| | - Hyukmin Lee
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea.
| | - Dongeun Yong
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea
| | - Seok Hoon Jeong
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea
| | - Kyungwon Lee
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea
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von Lengerke T, Kröning B, Lange K. Patients' intention to speak up for health care providers' hand hygiene in inpatient diabetic foot wound treatment: a cross-sectional survey in diabetes outpatient centres in Lower Saxony, Germany. PSYCHOL HEALTH MED 2016; 22:1137-1148. [PMID: 27998179 DOI: 10.1080/13548506.2016.1268696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Hand hygiene in wound care by health care providers (HCPs) is a key principle in treating hospitalized patients with diabetic foot infections. This study aimed to estimate the extent to which patients with type-2-diabetes (T2D) intend to speak up for HCPs' hand hygiene during inpatient foot treatment, test whether this motivation increases given the hospital would invite patients to speak up, and identify associations with socio-demographics, knowledge of hand hygiene requirements, and diabetes-related factors. A questionnaire-survey was conducted in eight diabetes outpatient centres in Lower Saxony/Germany. Intentions to speak up (without and with institutional encouragement) and knowledge about hand hygiene during foot-care were assessed. Analyses of variance were conducted, partly as repeated measures-models with intention-items as within-subject factor. N = 473 patients participated (response = 77.4%). N = 177 (41%) strongly intended to speak up. Institutional encouragement was associated with an increased rate of strong (54% vs. 41%; p < .001) and higher mean intention (M = 3.9 vs. 3.4 with vs. without encouragement [5-point-scales]; F(1, 434) = 41.5, p < .001). In patients without diabetic foot syndrome, this effect was limited to those with at least medium school education (F(2, 292) = 4.4, p = .013) and knowledge on HCPs' hand hygiene (F(2, 294) = 3.1, p = .047). In conclusion, a majority of T2D-patients in diabetes outpatient centres intend to speak for HCPs' hand hygiene in inpatient foot treatment, and are receptive to institutional encouragement. However, this presupposes at least medium education and knowledge about hand hygiene, emphasizing that patient empowerment begins with knowledge.
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Affiliation(s)
| | - Barbara Kröning
- a Hannover Medical School , Medical Psychology Unit , Hannover , Germany
| | - Karin Lange
- a Hannover Medical School , Medical Psychology Unit , Hannover , Germany
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Patient-centred hand hygiene information in orthopaedics units: an evidence-based implementation project. INT J EVID-BASED HEA 2016; 15:22-29. [PMID: 27875344 DOI: 10.1097/xeb.0000000000000094] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIM This project aimed to improve patients' knowledge on the importance of hand hygiene. It involved providing patients with a patient and family education on the importance of hand hygiene using a patient information leaflet that introduces the rationale of hand hygiene, possible consequences of poor hand hygiene, and the seven steps of hand hygiene. METHODS This projected used a preimplementation and postimplementation audit strategy using the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research Into Practice programs. The implementation occurred in three phases over a period of 6 months from January 2014 to June 2014. The audits took place in two orthopaedic wards in a large acute care setting tertiary hospital in Singapore and involved a sample size of 54 patients. It involved going through the medical records of the cases, assessment of patient knowledge based on the audit criteria, and checking if the patients received the patient information leaflet on hand hygiene. RESULTS The postimplementation audit found significant improvements in all three audit criteria. The percentage of patients who demonstrated knowledge in the importance of hand hygiene saw an improvement of 48.1%. There was an improvement of 44.5% in nurses' compliance to the documentation of patient education being carried out. The percentage of patients who received a patient information leaflet on hand hygiene saw an increase of 36.1%. CONCLUSION This project demonstrated that a preimplementation and postimplementation audit is a viable method to implement change and translate evidence into practice. Through this project, patients gained an understanding on the importance of hand hygiene and could take better ownership of their well being. This may potentially improve hospitalization experience and benefit health outcomes. The positive results of this project are contributed by the enthusiastic involvement of all the stakeholders, from patients and their caregivers to the bedside nurses and nursing leaders. The sustenance will be an ongoing challenge to the project.
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Caine LZ, Pinkham AM, Noble JT. Be seen and heard being clean: A novel patient-centered approach to hand hygiene. Am J Infect Control 2016; 44:e103-6. [PMID: 26856466 DOI: 10.1016/j.ajic.2015.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 11/18/2015] [Accepted: 11/19/2015] [Indexed: 11/29/2022]
Abstract
A quasiexperimental pre- and posttest design was used to evaluate hand hygiene (HH) rates on a medical-surgical unit. Data were collected by asking patients if they had seen or heard staff members cleaning their hands. Sixty-five percent of patients reported seeing or hearing staff perform HH preintervention and 93% reported observations postintervention (P < .001). Through incorporating an auditory cue we engaged patients while removing the burden placed on them to question health care worker behavior, and increased both staff and patient awareness of personal HH behavior.
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Affiliation(s)
- Lynda Z Caine
- Infection Prevention, Concord Hospital, Concord, NH.
| | | | - James T Noble
- Infectious Disease, Concord Hospital Medical Group, Concord, NH
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Cao J, Min L, Lansing B, Foxman B, Mody L. Multidrug-Resistant Organisms on Patients' Hands: A Missed Opportunity. JAMA Intern Med 2016; 176:705-6. [PMID: 26974592 PMCID: PMC5828500 DOI: 10.1001/jamainternmed.2016.0142] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Jie Cao
- Department of Pathology, University of Michigan Medical School, Ann Arbor
| | - Lillian Min
- Veterans Affairs Healthcare System, Geriatric Research, Education, and Clinical Center, Ann Arbor, Michigan3Division of Geriatric and Palliative Medicine, University of Michigan Medical School, Ann Arbor
| | - Bonnie Lansing
- Division of Geriatric and Palliative Medicine, University of Michigan Medical School, Ann Arbor
| | - Betsy Foxman
- School of Public Health, University of Michigan, Ann Arbor
| | - Lona Mody
- Veterans Affairs Healthcare System, Geriatric Research, Education, and Clinical Center, Ann Arbor, Michigan3Division of Geriatric and Palliative Medicine, University of Michigan Medical School, Ann Arbor
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Bellissimo-Rodrigues F, Pires D, Zingg W, Pittet D. Role of parents in the promotion of hand hygiene in the paediatric setting: a systematic literature review. J Hosp Infect 2016; 93:159-63. [PMID: 26996091 DOI: 10.1016/j.jhin.2016.02.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 02/04/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND When a child is hospitalized, parents have to share their role to protect the child with the hospital, and establish a partnership with healthcare workers to deliver safe care to the child, including undertaking good hand hygiene practices. AIM To review the scientific evidence about the participation of parents in the promotion of hand hygiene in paediatric settings. METHODS A systematic search of MEDLINE, EMBASE and SciELO databases was undertaken using the following terms: ('hand hygiene'[MeSH] OR 'hand hygiene' OR 'hand disinfection'[MeSH] OR hand disinf* OR hand wash* OR handwash* OR hand antisep*) AND (parent OR caregiver OR mother OR father OR family OR families OR relatives). The Integrated Quality Criteria for Review of Multiple Study Designs tool was used for quality assessment. FINDINGS The literature search yielded 1645 articles, and 11 studies met the inclusion criteria for the final analysis. Most studies were observational, and were based on questionnaires or interviews. Most parents had little knowledge about the indications to perform hand hygiene, but recognized hand hygiene as a relevant tool for the prevention of healthcare-associated infections. Their willingness to remind healthcare workers about a failed opportunity to perform hand hygiene was variable and, overall, rather low. Parents felt more comfortable about reminding healthcare workers about hand hygiene if they had previously been invited to do so. CONCLUSIONS Literature on the subject is scarce. The promotion of hand hygiene by parents should be further explored by research as a potential intervention for enhancing patient safety in paediatric settings.
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Affiliation(s)
- F Bellissimo-Rodrigues
- Infection Control Programme and World Health Organization Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland; Social Medicine Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - D Pires
- Infection Control Programme and World Health Organization Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - W Zingg
- Infection Control Programme and World Health Organization Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - D Pittet
- Infection Control Programme and World Health Organization Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
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