title: Empowering patients in the hospital as a new approach to reducing the burden of health care-associated infections: The attitudes of hospital health care workers.
abstract: BACKGROUND
  Any approach promoting a culture of safety and the prevention of health care-associated infections (HCAIs) should involve all stakeholders, including by definition the patients themselves. This qualitative study explored the knowledge and attitudes of health care workers toward the concept of patient empowerment focused on improving infection control practices.
  
  
  METHODS
  Semi-structured interviews were undertaken with 29 staff from a large hospital in Sydney, Australia.
  
  
  RESULTS
  There was virtually unanimous agreement among the participants that patients should be thought of as a stakeholder and should have a role in the prevention of HCAI. However, the degree of patient responsibility and level of system engagement varied. Although very few had previously been exposed to the concept of empowerment, they were accepting of the idea and were surprised that hospitals had not yet adopted the concept. However, they felt that a lack of support, busy workloads, and negative attitudes would be key barriers to the implementation of any empowerment programs.
  
  
  CONCLUSIONS
  Although the World Health Organization has recommended that patients have a role in encouraging hand hygiene as a means of preventing infection, patient engagement remains an underused method. By extending the concept of patient empowerment to a range of infection prevention opportunities, the positive impact of this intervention will not only extend to the patient but to the system itself.
authors.affiliation: School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia. Electronic address: h.seale@unsw.edu.au.
authors.forename: Holly
authors.initials: H
authors.lastname: Seale
authors.affiliation: School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Abrar A
authors.initials: AA
authors.lastname: Chughtai
authors.affiliation: School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Rajneesh
authors.initials: R
authors.lastname: Kaur
authors.affiliation: Centre for Health Initiatives, University of Wollongong, Wollongong, Australia.
authors.forename: Lyn
authors.initials: L
authors.lastname: Phillipson
authors.affiliation: UNSW Medicine, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Yuliya
authors.initials: Y
authors.lastname: Novytska
authors.affiliation: School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Joanne
authors.initials: J
authors.lastname: Travaglia
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001315:Australia; D003428:Cross Infection / Q000517:prevention & control*; D005260:Female; D006761:Hospitals; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D011361:Professional Competence
keywords: Empowerment; Health care worker; Health care–acquired infection; Hospital; Infection control; Patient