Infection Prevention Control & Organisational Patient Safety Culture
Research type
Research Study
Full title
Infection Prevention Control and Organisational Patient Safety Culture Within the Context of Hospital Isolation
IRAS ID
229788
Contact name
John Gammon
Contact email
Sponsor organisation
Swansea University
Clinicaltrials.gov Identifier
RIO 005-18, Sponsor Reference Number - Swansea University
Duration of Study in the UK
1 years, 6 months, 1 days
Research summary
Research Summary
What We Know:
Infections present real risk of harm and sometimes death within and outside healthcare. In recent years, there have been high profile successes in infection prevention control (IPC), such as the dramatic reductions in methicillin-resistant Staphylococcus aureus bloodstream infections and Clostridium difficile in the UK. Nevertheless, healthcare associated infections (HCAIs) continue to occur and continue to present a risk to users of healthcare.What We Do Not Know:
We do not know the meaning of IPC ‘ownership’ for health workers and the ways in which ownership can form part of a wider complex intervention to improve IPC and patient safety.
We do not understand the positioning of IPC principles, strategies and practices within the broader context of organisational patient safety culture and the ways in which these principles, strategies and practices shape and inform patient safety culture, and vice-versa.What We Will Do:
We will invite staff at two hospital sites to participate in Manchester Patient Safety Framework (MaPSaF) workshops. This will facilitate staff to reflect on patient safety culture, assist them in understanding how a mature safety culture may look and identify focus issues for change and improvement.
We will interview patients, carers and staff on selected wards within isolation settings in two hospitals to gain their understanding of IPC and patient safety.
We will observe IPC and patient safety processes and procedures on a number of hospital wards within isolation settings, at the two hospital sites.
We will triangulate these methods to give a global picture of IPC and patient safety culture within the context of isolation settings at the two hospital sites.How Will Hospital Patients Benefit From This Research?
From our findings we will produce guidance for policy makers, health boards and hospitals on how best to understand and improve IPC, patient safety and patient safety culture in hospital isolation settings.Summary of Results
Knowledge, awareness and understanding of infection prevention and patient safety culture within hospital isolation settings is crucial to promoting and delivering safe, appropriate and effective care to patients within the NHS.
In theorising and positioning patient safety as a space of social struggle, the study illustrates the complexities of patient safety culture.
The engagement of nursing staff and other healthcare workers with infection prevention and patient safety initiatives, procedures and practices takes place in complex hospital environments and in circumstances where time and resources are most often stretched. Where work of one form is relentlessly squeezed by other demands.
This study confirms the collective nature of healthcare to patient safety and infection prevention, as well as emphasising the individual efforts of those people working within nursing and wider healthcare in preventing harm.
Positioned within a context of healthcare restructuring, both hospital sites where the research took place are at very different places in regard to levels of patient safety culture maturity.
Hospital site A has a largely positive cultural and emotional context.The mantle of uncertainty appears to be impacting most acutely at Hospital Site B, with the uncertainties of the restructuring process impacting on the safety of patients. The largely broken structural, political, emotional, educational and cultural context identified at Hospital Site B, appears especially challenging for the development of a mature patient safety culture.
The value of Bourdieu’s insights to infection prevention and patient safety culture lie in their focus on everyday practice. Bourdieu’s notions of field, capital and habitus reveal the taken for granted intricacies of the work nursing staff and other healthcare workers perform and position them within the wider economic field.
Bourdieu offers a means of capturing the less visible aspects of healthcare. Understanding the habitus of this group of people may make it easier to design effective interventions where complex issues such as patient safety culture and infection prevention are involved.
REC name
Wales REC 7
REC reference
18/WA/0113
Date of REC Opinion
27 Mar 2018
REC opinion
Favourable Opinion