Talking with patients: Improving clinician-patient communication around healthcare-associated infections using video-reflexive methods

Dr Mary Wyer1,2, Dr Su-Yin Hor1,2,3, Ms Ruth Barratt1, Ms Kathy Dempsey4, Professor Lyn Gilbert1,2,4,5

1Westmead Institute for Medical Research, Westmead, NSW, Australia
2Sydney Health Ethics, University of Sydney, Sydney, NSW, Australia
3Faculty of Health, University of Technology, Sydney, NSW, Australia
4Westmead, WSLHD, Westmead, NSW, Australia
5Marie Bashir Institute for Infectious Diseases & Biosecurity, Sydney, NSW, Australia


INTRODUCTION: Patient participation is increasingly recognised as a crucial component of successful infection prevention and control (IPC). However, limited clinician-patient communication about IPC and healthcare associated infections means that patients may have inadequate understandings of transmission, and varying understandings of IPC strategies. Some clinicians can find these conversations with patients challenging. This paper presents findings from a study aimed at improving clinician-patient communication around the screening, identification of multi-drug resistant organism (MRO) carriage and its implications, with a broader aim of increasing patient involvement in IPC.

METHODS: The research was undertaken at a large metropolitan hospital in Sydney. Video recordings were made of the patient screening process in the adult renal unit, the laboratory and the IPC offices, including clinician-patient communication at the bedside. This footage was shown to patients for their comments. Patients’ comments were added to the pool of edited video clips about the screening process, which were then shown to nurses, IPC practitioners and laboratory staff to generate discussion and strategies for improving current communication practices.

RESULTS: Participants were able to identify communication gaps, opportunities and strategies when viewing the clips of the MRO screening process. In particular, nurses were able to better appreciate the informational needs of their patients, and to design resources to support their communication with patients during this process.

CONCLUSION: Video-reflexive methods enable healthcare professionals to view their communication practices from their patients’ and colleagues’ perspectives, and to better understand how they can shape patients’ understandings and precautions around infection risks and behaviours.


Mary Wyer is a nurse and a researcher at the Westmead Institute for Medical Research, Sydney. Her research is currently funded by the APPRISE Centre of Research Excellence. She researches collaboratively with healthcare workers, patients and families, using video-reflexive ethnography, to understand and improve infection prevention and control practices. Her specific focus is on roles patients play in preventing infection transmission.

Su-yin Hor is a social scientist and lecturer in Health Services Management at the University of Technology, Sydney. She specialises in patient safety and collaborative learning in acute care settings. She has published on patient safety in relation to accountability, incident reporting, patient involvement, communication and space, infection prevention and control, and video-reflexive ethnography. Her current research uses participatory video-reflexive methods with healthcare staff and patients to improve infection prevention and control practices at the frontline of clinical care.

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