title: Communication interventions to improve adherence to infection control precautions: a randomised crossover trial.
abstract: BACKGROUND
  Ineffective 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.
  
  
  METHODS
  Two 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.
  
  
  RESULTS
  300 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%).
  
  
  CONCLUSIONS
  Simple 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.
authors: Centre for Health Informatics, University of New South Wales, Sydney, Australia. m.ong@unsw.edu.au
authors: Mei-Sing
authors: MS
authors: Ong
authors: Farah
authors: F
authors: Magrabi
authors: Jeffrey
authors: J
authors: Post
authors: Sarah
authors: S
authors: Morris
authors: Johanna
authors: J
authors: Westbrook
authors: Wayne
authors: W
authors: Wobcke
authors: Ross
authors: R
authors: Calcroft
authors: Enrico
authors: E
authors: Coiera
mesh_terms: D016009:Chi-Square Distribution; D003142:Communication; D003266:Continuity of Patient Care / Q000592:standards*; D018592:Cross-Over Studies; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006282:Health Personnel; D006801:Humans; D017053:Infection Control / Q000379:methods* / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data; D011872:Radiology Department, Hospital; D014187:Transportation of Patients / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data
references: J Hosp Infect. 2001 Mar;47(3):198-209
references: 11247680
references: Clin Infect Dis. 1996 Oct;23(4):767-72
references: 8909842
references: Infect Control Hosp Epidemiol. 2001 Nov;22(11):693-6
references: 11842989
references: Am J Infect Control. 2006 Oct;34(8):476-83
references: 17015152
references: Am J Infect Control. 1994 Jun;22(3):138-48
references: 7943924
references: Crit Care Med. 2001 Feb;29(2):405-12
references: 11246324
references: Ann Intern Med. 1995 Jan 15;122(2):90-5
references: 7993001
references: J Opt Soc Am. 1981 Jun;71(6):723-9
references: 7252614
references: J Clin Nurs. 2008 Jan;17(2):157-67
references: 17331098
references: J Trauma. 1990 May;30(5):555-8; discussion 558-61
references: 2342138
references: Lancet. 2009 Aug 8;374(9688):443
references: 19665635
references: J Infect Dis. 1982 Jun;145(6):875-85
references: 7086199
references: BMC Health Serv Res. 2010 Dec 20;10:342
references: 21171967
references: J Hosp Infect. 2005 Feb;59(2):77-82
references: 15702513
references: BMJ. 1998 Aug 8;317(7155):362-3
references: 9694748
references: J Occup Environ Med. 1997 Feb;39(2):130-7
references: 9048319
references: Anesth Analg. 2005 Jul;101(1):246-50, table of contents
references: 15976240
references: BMJ. 2010 Jan 13;340:b5433
references: 20071413
references: Crit Care. 2009;13(6):210
references: 20064195
references: J Crit Care. 2006 Sep;21(3):231-5
references: 16990087
references: Qual Saf Health Care. 2010 Oct;19(5):e32
references: 20671076
references: Am J Med. 1987 Jul;83(1):129-36
references: 3605164
references: Am J Infect Control. 2007 Dec;35(10 Suppl 2):S65-164
references: 18068815
references: Arch Intern Med. 2005 Feb 14;165(3):302-7
references: 15710793
references: Infect Control Hosp Epidemiol. 2002 Dec;23(12 Suppl):S3-40
references: 12515399
references: Ann Intern Med. 1999 Aug 17;131(4):269-72
references: 10454948
references: Curr Opin Infect Dis. 2004 Aug;17(4):329-33
references: 15241077
references: Infect Control Hosp Epidemiol. 2003 Sep;24(9):679-85
references: 14510251
references: Lancet Infect Dis. 2008 May;8(5):289-301
references: 18471774
references: Eval Health Prof. 2004 Mar;27(1):34-44
references: 14994558
references: Am J Infect Control. 1995 Aug;23(4):225-36
references: 7503434
references: Am J Epidemiol. 1994 Aug 1;140(3):279-89; discussion 300-1
references: 8030631
references: Am J Med. 2006 Mar;119(3):275.e15-23
references: 16490475