WHO Guidelines on Hand Hygiene in Health Care - Safe Care ...

APPENDICES
Risk communication
We were informed by the ward nurses that Mum had contracted
a “little, of no concern” infection. We were given a broadsheet
A4 paper with the initials MRSA and what they stood for, there
was no other information given to my family whatsoever … 20
hours later she was in a coma and died 11 days later
(narrative, United Kingdom).
Building on the earlier questions exploring how best to
communicate risks within the context of HCAI, the narrative
forms explored both how the individuals had been informed
of the acquired infection and whether they had been informed
about any risk of HCAI whilst receiving care/treatment (Table 7).
Table 7.
Patient narrative – risk communication
Country Infection/organism How told Informed of risk of HCAI while in hospital?
India HIV Report Not answered
United Kingdom MRSA Verbal No
USA Septicaemia Verbal No
Australia Urinary tract infection Not told No
USA Urinary tract infection Not told No
United Kingdom MRSA Verbal No
USA MRSA Not told No
USA Septicaemia Not told No
USA Wound Verbal No
United Kingdom C. difficile Leaflet No
United Kingdom MRSA “Had to ask” No
Conclusion
The results of this study reinforce a number of findings from
previous studies. Many individuals who have had an experience
as a patient are interested in the possibilities of participating
in hand hygiene improvement among HCWs in health-care
settings. Most respondents are interested in and positive about
empowerment; however, there were a number of caveats. The
following action areas should be considered by any country or
facility intent on introducing or strengthening this component of
the strategy:
• infrastructure for hand hygiene;
• patient and HCW information and education;
• risk communication;
• alignment with culture.
In particular, the survey reinforces the importance of programme
development and the need for any patient empowerment
strategy to be at one with the organizational culture and
context. The survey results present an endorsement that patient
empowerment should form one component of a multimodal
hand hygiene improvement strategy.
Limitations of the study
The survey was targeted at individuals having a health-care
encounter as a patient. However, distribution channels (<strong>WHO</strong>
Patients for Patient Safety Champions and members of the
International Alliance of Patient Organizations) inevitably resulted
in sample bias with a high percentage of respondents being
both patients and also involved in some way in the health-care
sector, which limits the capacity for generalizing these results to
the population as a whole. It is probable also that respondents
were sensitized to the issues surrounding HCAI during the
survey and replied to certain questions in a manner that might
be considered as a socially acceptable response. Although
limited, the number of responses from the African, South-East
Asia, Eastern Mediterranean, and Western Pacific Regions
are useful for comparative purposes, and further work will be
required in the future to gain a greater understanding of patient
perception in these regions.
1
Patient empowerment (pilot web site). London, National Patient Safety Agency, 2008 (http://www.npsa.nhs.uk/cleanyourhands/in-hospitals/pep/,
accessed 1 December 2008)
2
Zorzi R. Evaluation of a pilot test of the provincial hand hygiene improvement program for hospitals - final report. Toronto, Cathexis Consulting Inc., 2007.
3
McGuckin M, Waterman R, Shubin A. Consumer attitudes about health care-acquired infections and hand hygiene. American Journal of Medical
Quality, 2006, 21:342-346.
4
Aleccia J. The dirty truth about docs who don’t wash: Patients shouldn’t be shy about asking providers to hit the sink, experts say. Microsoft web site,
Health page, 2008 (http://www.msnbc.msn.com/id/22827499, accessed 26 November 2008).
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