Patient involvement in hygiene initiatives: How do health care professionals feel about?

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According to a review, published online February 8 in the Journal of Clinical Nursing, patient involvement may promote hand washing in the hospital. We interviewed author Mamdooh Alzyood (Doctoral Researcher, Oxford Brookes University), who gave us also some personal thoughts about Semmelweis at the end of the interview.

Mr. Alzyood, I was astonished to read that an overall positive attitude toward patient involvement was related to how patients asked and how HCPs (health care professionals) responded to being asked (I often have read that HCPs feel annoyed when they are asked by patients!)

It is based on the evidence collected from 19 studies which represent data from 3400 patients, 1174 families/parents, and 3077 healthcare professionals from countries around the world.The review reported that a request to ask patients to prompt HCPs (predominantly nurses and doctors, but not only them) to wash their hands is, in reality, far from simple. Patients and HCPs have mixed views of patients asking about hand hygiene. Some patients are happy to ask about HH and HCPs are happy to accept the reminder, but this was mainly conditional to the way that patients ask and the way that HCPs respond to the reminder.

What, do you think was the reason for the widespread acceptance of the fact that patients asked? 

There are several factors reported to increase patient willingness to ask HCPs to wash their hands, such as knowing the name of the care provider and receiving encouragement from HCPs to ask. As reported in other studies included in our review, patients are more willing to remind nurses than doctors to wash their hands. But there is a notable variation between the positive attitude toward asking and the actual intention to ask nurses or doctors to wash their hands. Education and raising awareness for patients and healthcare professionals would help encourage patients to ask and nurses to accept the reminder.

On your profile-site of the Oxford Brookes University, I learn that your thesis title is exactly about this issue. What animated you to focus on this issue?

My background is as a Registered Nurse; I worked clinically within the fields of emergency, cardiac, acute and intensive care. I hold an MSc in Infection Prevention and Control from Oxford Brookes University. Reading various journal articles and online op-eds on preventing lethal hospital infection(s) energised me to look for certain procedures can minimise the risk associated with hospital-acquired infections. I have lost two of my best friends as well as family members to sepsis, a potentially fatal complication of an infection in the bloodstream, and unfortunately I couldn’t help them at the time. Most research on preventing infection emphasises the importance of hand hygiene! Yet in most studies the compliance rate was not satisfactory and varies between countries, as well as hospitals and even individual hospital units. Looking for feasible interventions that could enhance hand hygiene compliance I got the impression that current research was primarily focused on complicated strategies and technologies to monitor healthcare professionals’ hand hygiene. However, they did not consider that we actually already have an in-house way of promoting hand hygiene, a solution from within! We have patients and they should be part of the solution. Perhaps patients should also be involved in reminding us to wash our hands. How can I work to make it a norm in the hospital setting for patients to ask about hand hygiene?

HAI due to a lack of hand hygiene is still a big problem in most hospitals worldwide. What should be done to increase hand hygiene compliance, and do you think that patient involvement could be, in the future, an important part in the fight against HAI?

As is already known, no single intervention could enhance hand hygiene compliance. It is a set of interventions that could work in tandem to enhance compliance rates. More research is needed to understand the views and experiences of patients and healthcare professionals with what works best for them to promote hand hygiene. Quantitative research alone is not enough to address this issue. We need to dig deeper into people’s experiences, attitudes and views, and understand their behaviours to be able to reach a sensible strategy that could enhance hand hygiene compliance and one which is acceptable for all patients and HCPs. This is what my doctoral research is about.

We, the Semmelweis Foundation are celebrating together with the medical university Vienna (June, 21) the 200th birthday of Ignaz Semmelweis (July, 1). What does he mean professionally and personally to you?

Professionally, hand hygiene is a key in preventing lethal hospital infections. The work Semmelweis conducted inspires healthcare professionals in so many ways! He showed courage and dedication in proving to others that hand hygiene is important, and that we can do something to stop the spread of infection that kills our loved ones on a daily basis. Personally, I think the story of Semmelweis defending and convincing others about the importance of hand hygiene should happen every day by healthcare professionals! We all have to represent Semmelweis at our workplace! We have to be able to investigate the things that are happening around us: looking for the evidence “Why this happened” and “What can I do?” and in doing so we continue emphasising the message that Semmelweis promoted in 1846.

 

 

 

 

 

 

 

 

 

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About Author

Carola Timmel is journalist for print and radio and professional speaker. Her focus lies on the topic Medicine & Health.

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