Patient Involvement Can Affect Clinicians’ Perspectives and Practices of Infection Prevention and Control

Wyer, Mary; Iedema, Rick; Hor, Su-yin; Jorm, Christine; Hooker, Claire; Gilbert, Gwendolyn L.

doi:10.1177/1609406917690171

Cited by 33 publications

(42 citation statements)

References 42 publications

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“…Patients felt able to raise issues "through a third party" and reduced the potential for patients and staff to deal with confrontational moments; "brokering new relationships between them". 37 There is value in involving patients and relatives beyond the point of care, either during the intervention design stage or following discharge to support collaborative working in IPC. This would help staff to optimize their IPC practice when patients lack capacity or present IPC risks.…”

Section: Comparison With Previous Literature and Implications For Pmentioning

confidence: 99%

Making infection prevention and control everyone's business? Hospital staff views on patient involvement

Sutton

Brewster

Tarrant

2019

Health Expectations

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Context Ensuring an infection‐free environment is increasingly seen as requiring the contribution of staff, patients and visitors. There is limited evidence, however, about how staff feel about collaborating with patients and relatives to co‐produce that environment. Aims This study aims to understand how hospital staff perceive the involvement of patients and relatives in infection prevention and control (IPC) and the main challenges for staff in working together with patients and relatives to reduce the threat of infection. Methods Qualitative semi‐structured interviews were conducted with 35 frontline health‐care professionals and four executive staff, from two hospital trusts. Findings We found that staff were more supportive of approaches that encourage co‐operation from patients and relatives, than of interventions that invoked confrontation. We identified challenges to involvement arising from staff concerns about shifting responsibility for IPC onto patients. Staff were not always able to work with patients to control infection risks as some patients themselves created and perpetuated those risks. Conclusions Our work highlights that IPC has particular features that impact on the possibilities for involving patients and relatives at the point of care. Staff acknowledge tensions between the drive to involve patients and respect their autonomy, and their duty to protect patients from risk of unseen harm. The role that patients and relatives can play in IPC is fluctuating and context dependent. Staff responsibility for protecting patients from the risk of infection may sometimes need to take priority over prerogatives to involve patients and relatives in the co‐production of IPC.

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Section: Comparison With Previous Literature and Implications For Pmentioning

confidence: 99%

Making infection prevention and control everyone's business? Hospital staff views on patient involvement

Sutton

Brewster

Tarrant

2019

Health Expectations

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“…Similar to the suggestion of Wyer et al (2017), showing patients’ comments to staff can enable the team to consider how they might tackle complex situations in new ways. Viewing the videos of patients’ stories opened a space and encouraged the staff to talk about their practice and the actions of others.…”

Section: Discussionmentioning

confidence: 99%

Using Video-Reflexive Ethnography to Engage Hospital Staff to Improve Dementia Care

Hung

Phinney

Chaudhury

et al. 2018

Global Qualitative Nursing Research

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In this article, we discuss how video-reflexive ethnography may be useful in engaging staff to improve dementia care in a hospital medical unit. Seven patients with dementia were involved in the production of patient-story videos, and fifty members of staff (nurses, physicians, and allied health practitioners) participated in video-reflexive groups. We identified five substantial themes to describe how video-reflexive groups might contribute to enacting person-centered care for improving dementia care: (a) seeing through patients’ eyes, (b) seeing normal strange and surprised, (c) seeing inside and between, (d) seeing with others inspires actions, and (e) seeing with the team builds a culture of learning. Our findings suggest that video reflexivity is not only useful for staff engagement but also effective in enhancing team capacity to enact person-centered care in the hospital setting.

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“…The safe zone is where one can speak freely about the way things are done and for what reason, and where there is no need to pretend that things are better than they actually are. Providing a safe zone is not only a necessary requirement in group video-reflexive sessions both also in oneon-one video-reflexive meetings (e.g., Collier & Wyer, 2015;Wyer, Iedema, Hor, Jorm, Hooker, & Gilbert, 2017). The role of the facilitator in these video-reflexive sessions is crucial in order to create and maintain such a safe zone.…”

Section: Opening Up Practices: An Exnovative Approach and The Methods mentioning

confidence: 99%

Blending Video-Reflexive Ethnography With Solution-Focused Approach: A Strengths-Based Approach to Practice Improvement in Health Care

Mesman

Walsh

Kinsman

et al. 2019

International Journal of Qualitative Methods

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Professionals seldom discuss those things that go well-rather the focus is often on problems, poor outcomes, and what does not go well. Exnovation is about illuminating the invisible or hidden strengths of existing practices in order to improve practice and is central to the contemporary, qualitative elicitation method: video-reflexive ethnography (VRE). VRE is a method to explore and articulate the taken for granted by means of short video clips of one’s own work practice that provides a basis for sharing experiences, assumptions, questions, and concerns about the way things are done in order to effect practice improvement. Reflexivity is key to the method. The creation of a safe space for this shared reflexivity is essential. Improvement activities frequently draw upon problem-focused approaches that imply blame and fault. Such approaches can serve to close down discussion, give rise to anxiety, and inhibit the very improvements sought. In contrast, a strengths-based, solution-focused approach serves to create the safe place where shared practices, rather than individuals, are the center of attention. By focusing on what works well practitioners are encouraged to identify and build on existing strengths. A solution-focused approach used alongside VRE provides a scaffold for building improvement that is relevant to context. In this article, we discuss exnovation, the elicitation method of video-reflexivity, and the incorporation of a strengths-based solution-focused approach with VRE. We highlight the transformative and complementary qualities of these methods and draw upon practical examples from health care to demonstrate how they serve to strengthen and enhance each other.

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Patient Involvement Can Affect Clinicians’ Perspectives and Practices of Infection Prevention and Control

Cited by 33 publications

References 42 publications

Making infection prevention and control everyone's business? Hospital staff views on patient involvement

Making infection prevention and control everyone's business? Hospital staff views on patient involvement

Using Video-Reflexive Ethnography to Engage Hospital Staff to Improve Dementia Care

Blending Video-Reflexive Ethnography With Solution-Focused Approach: A Strengths-Based Approach to Practice Improvement in Health Care

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