1 Westmead InsCtute for Medical Research 2 Faculty of Health, - PowerPoint PPT Presentation

Talking with patients: Improving clinician-patient communication around healthcare-associated infections using video-reflexive methods Mary Wyer 1,3 , Suyin Hor 1,2 , Lyn Gilbert 1,3 , Ruth Barra: 1 , Kathy Dempsey 4 1 Westmead InsCtute for Medical Research 2 Faculty of Health, University of Technology, Sydney 3 Marie Bashir InsCtute, University of Sydney 4 InfecCon PrevenCon and Control, Westmead Hospital Email: mary.wyer@sydney.edu.au Twi:er: @mary_wyer

R E V I E W An integrative review exploring the perceptions of patients and healthcare professionals towards patient involvement in promoting hand hygiene compliance in the hospital setting Mamdooh Alzyood MSc, BSc, RN, Doctoral Student | Debra Jackson PhD, FACN, Professor | Joanne Brooke CPsychol, MSc, RN, Reader in Complex Older Persons Care | Helen Aveyard PhD, MA, RGN, Senior Lecturer Faculty of Health and Life Sciences, Oxford Aims and objectives: To review patients ’ and healthcare professionals ’ perceptions of Institute of Nursing, Midwifery, and Allied Health Research (OxINMAHR), Oxford patient involvement in promoting hand hygiene compliance in the hospital setting. Brookes University, Oxford, UK Background: Initiatives continue to emphasise the importance of involving patients in Correspondence their safety at the point of care. A patient-centred care approach aimed to empower Mamdooh Alzyood, Faculty of Health and patients to become active members of the healthcare team. However, understanding the Life Sciences, Oxford Institute of Nursing, Midwifery, and Allied Health Research perceptions of patients and healthcare professionals of patient involvement in promoting (OxINMAHR), Oxford Brookes University, hand hygiene compliance among healthcare professionals has yet to be fully explored. Oxford, UK. Design: Integrative literature review. Email: mamdooh.alzyood-2015@brookes.ac. uk Methods: A five-stage review process informed by Whittemore and Knafl ’ s method- Relevance to clinical practice: Simple messages promoting patient involvement may Funding information ology was conducted. MEDLINE and CINAHL were searched for papers published The project is self-funded by the doctoral between January 2009 – July 2017. Data were extracted manually, organised using researcher and the main author of this article. NVivo 11 and analysed using thematic analysis. Results: From an identified 240 papers, 19 papers were included in this review. The- lead to complex reactions in both patients and healthcare professionals. It is unclear, matic analysis revealed two main themes with three related subthemes. Patients were willing to remind healthcare professionals (especially nurses) to wash their hands, health- care professionals perception towards patients ’ involvement varied from one study to yet how patients and staff react to such messages in clinical practice. There is a need 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 for a deeper understanding of how they can work together to support harm free care. 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. K E Y W O R D S 2 hand hygiene compliance, integrative review, patient engagement, patient involvement, patient participation

Talking with patients • CollaboraCon between WIMR, renal unit staff & paCents, ICPs, ID physicians, and laboratory staff • Aim: To improve clinician-pa(ent communica(on around HAIs and IPC, with the broader aim of reducing HAIs by increasing paCent involvement in IPC

Working with parCcipants to video pracCces of interest, and then showing back the footage to them in reflexive sessions § Engages with the experCse of frontline staff/paCents/visitors § Makes explicit the complex reality of clinical work § Raises awareness of taken-for-granted pracCces & relaConships § Results in learning and change (pracCce opCmizaCon)

Video-reflexivity Working party Researcher analysis Research disseminaCon Drawing on Mesman & Carroll (2018)

References • Alzyood, M., Jackson, D., Brooke, J., & Aveyard, H. (2018). An integrative review exploring the perceptions of patients and healthcare professionals towards patient involvement in promoting hand hygiene compliance in the hospital setting. Journal of clinical nursing , 27(7-8), 1329-1345. • Australian Commission on Safety and Quality in Health Care [ACSQHC]. (2011). National safety and quality health service standards . Sydney, NSW: ACSQHC. • Burnett, E., Johnston, B., Kearney, N., Corlett, J., & MacGillivray, S. (2013). Understanding factors that impact on public and patient's risk perceptions and responses toward Clostridium difficile and other health care-associated infections: a structured literature review. American Journal of Infection Control, 41 (6), 542-548. doi:10.1016/j.ajic.2012.05.026 • Davis, R. E., Parand, A., Pinto, A., & Buetow, S. (2015). Systematic review of the effectiveness of strategies to encourage patients to remind healthcare professionals about their hand hygiene. Journal of Hospital Infection, 89 (3), 141-162. doi:10.1016/j.jhin.2014.11.010 • Gould, D. J., Drey, N. S., Millar, M., Wilks, M., & Chamney, M. (2009). Patients and the public: Knowledge, sources of information and perceptions about healthcare-associated infection. Journal of Hospital Infection, 72 (1), 1-8. doi:10.1016/j.jhin.2009.01.024 • Hor, S., Carroll, K., Collier, C., Lenne, B., & Wyer, M. (2016). Analysis on the run: Redefining and locating analysis in video-reflexive ethnography. Paper presented at the ACSPRI Social Science Methodology Conference, University of Sydney, Australia. • Iedema, R., Hor, S., Wyer, M., Gilbert, G. L., Jorm, C., Hooker, C., & O'Sullivan, M. V. N. (2015). An innovative approach to strengthening health professionals’ infection control and limiting hospital-acquired infection: video-reflexive ethnography. BMJ Innovations . • Iedema, R., Mesman, J., & Carroll, K. (Eds.). (2013). Visualising Health Care Practice Improvement . London: Radcliffe. • Levinson, W., Lesser, C. S., & Epstein, R. M. (2010). Developing physician communication skills for patient-centered care. Health Aff (Millwood), 29 (7), 1310-1318. doi:10.1377/hlthaff.2009.0450 • Longtin, Y., Sax, H., Leape, L. L., Sheridan, S. E., Donaldson, L., & Pittet, D. (2010). Patient participation: Current knowledge and applicability to patient safety. Mayo Clinic Proceedings, 85 (1), 53-62. doi:10.4065/mcp.2009.0248 • Mutsonziwa, G., & Green, J. (2011). Colonised and isolated: A qualitative metasynthesis of patients’ experiences of being infected with multiple drug resistant organisms and subsequent isolation. Healthcare infection, 16 (4), 147-155. doi:10.1071/hi11020 • NHMRC. (2010). Australian guidelines for the prevention and control of infection in healthcare: Commonwealth of Australia. • Wyer, M., Jackson, D., Iedema, R., Hor, S., Gilbert, G. L., Jorm, C., . . . Carroll, K. (2015). Involving patients in understanding hospital infection control using visual methods. Journal of Clinical Nursing, 24 (11-12), 1718-1729. doi:10.1111/jocn.12779