Communication interventions to improve adherence to infection control precautions: a randomised crossover trial

Abstract

BackgroundIneffective communication of infection control requirements during transitions of care is a potential cause of non-compliance with infection control precautions by healthcare personnel. In this study, interventions to enhance communication during inpatient transfers between wards and radiology were implemented, in the attempt to improve adherence to precautions during transfers.MethodsTwo interventions were implemented, comprising (i) a pre-transfer checklist used by radiology porters to confirm a patient’s infectious status; (ii) a coloured cue to highlight written infectious status information in the transfer form. The effectiveness of the interventions in promoting adherence to standard precautions by radiology porters when transporting infectious patients was evaluated using a randomised crossover trial at a teaching hospital in Australia.Results300 transfers were observed over a period of 4 months. Compliance with infection control precautions in the intervention groups was significantly improved relative to the control group (p < 0.01). Adherence rate in the control group was 38%. Applying the coloured cue resulted in a compliance rate of 73%. The pre-transfer checklist intervention achieved a comparable compliance rate of 71%. When both interventions were applied, a compliance rate of 74% was attained. Acceptability of the coloured cue was high, but adherence to the checklist was low (40%).ConclusionsSimple measures to enhance communication through the provision of a checklist and the use a coloured cue brought about significant improvement in compliance with infection control precautions by transport personnel during inpatient transfers. The study underscores the importance of effective communication in ensuring compliance with infection control precautions during transitions of care.

The Interventions to Improve Standard Precautions (Sp) Knowledge and Practice Among Healthcare Workers (Hcws): A Systematic Review

“…Both interventions improved compliance to Standard Precautions such as hand hygiene, glove and gown use, and overall adherence with infection control recommendations. However, this randomised crossover trial did not report the effect of both interventions on SP knowledge and MRSA prevalence (Ong et al, 2013). Overall, both interventions led to increase compliance to SP.…”

“…They are either education intervention alone or with additional infection control support strategies or with theory-based intervention module. Other intervention strategies were selfinstructed computer module with clinical case simulation and another study use a checklist and coloured cues as intervention (Kappes Ramirez, 2018;Ong et al, 2013). There is also a study evaluating the effect of California Healthcare-Associated Infection Prevention Initiative (CHAIPI) which provides intervention in the form of comprehensive technology services model that can identify and track infection outbreaks earlier, track antibiotic resistance, and mine data related to HAIs (Halpin et al, 2013).…”

“…Another five studies assessed only the knowledge related to infection control in reducing HAIs (Chauhan & Kumari, 2016;Edet et al, 2010;Kappes Ramirez, 2018;Rajini & Kalyani, 2016;Rose, 2015). Meanwhile three studies measured the score of practice of SP alone (Baldwin et al, 2010;Halpin et al, 2013;Ong et al, 2013).…”

Moving beyond hand hygiene monitoring as a marker of infection prevention performance: Development of a tailored infection control continuous quality improvement tool

“…36 This is compounded by the considerable variation in the scope, approach, content, expectations, and terminology in infection control guidance and recommendations. 37,38 Improving and clarifying infection control information and expectations may improve compliance, 39 knowledge and high levels of self-efficacy are recognized to improve performance, 40 whereas poor self-efficacy, despite good theoretical knowledge, is more likely to be associated with lower compliance. 25…”

Suboptimal infection prevention and control in the healthcare culture

“…77,78 Poor examples by superiors can cultivate a culture of non-compliance. 79 For example a paediatric resident commented, "…the staff physician had…walked out [without washing his hands] …at that point I almost felt like maybe I shouldn't have done that (washed hands)." 20 Conversely "…after seeing that the attending physician had washed his hands, all the others followed suit."…”