The role of communication in the alteration of patient-care practices in hospital--a prospective study.
In infection control, ward practices often need alteration, as in Queen Mary Hospital, Hong Kong, when a policy was introduced to discontinue the recapping of needles among nurses. Nine randomly selected wards were divided into three groups (A, B and C) of 3 wards each. From an initial survey, nurses were divided into those who agreed with the discontinuation (the 'agreeables') and those who did not (the 'non-agreeables'). Methods used to introduce the policy included a simple announcement through the nursing hierarchy in group A (control), a passive method (posters and pamphlets) was added in group B and both passive and active methods (in-service lectures) were used in group C. Five weeks later, behavioural change was assessed by another survey and by an unannounced direct needle-count. Only 21% of the nurses changed their practice by simple announcement. For the 'agreeables', 85% changed by the passive method and no further improvement was observed when the active method was added. However, 83% of the 'non-agreeables' changed their practice when the active method was used while the passive method alone changed only 21%. Six months later, a third survey indicated that when the active method was included the change persisted at over 85%, while a 36% change was noted for the 'agreeables' who were only exposed to the passive method.
Seto
W H
WH
Department of Microbiology, University of Hong Kong.
Ching
P T
PT
Fung
J P
JP
Fielding
R
R
D003142:Communication; D003299:Cooperative Behavior; D003428:Cross Infection / Q000209:etiology / Q000517:prevention & control*; D006723:Hong Kong; D006746:Hospital Bed Capacity, 500 and over; D006784:Hospitals, Teaching; D006801:Humans; D009339:Needles; D009741:Nursing Staff, Hospital / Q000193:education* / Q000523:psychology; D011446:Prospective Studies; D013997:Time Factors; D014951:Wounds, Stab / Q000150:complications / Q000517:prevention & control*