To survey or not to survey? Evaluating the quality of patient experience feedback for aseptic technique compliance assessment

Ms Megan Gritt1, Ms  Susanne  Collings1, Ms Shirley  Leong1, Ms Pauline  Bass1, Associate Professor  Leon  Worth1

1Alfred Health, Melbourne , Australia


Patient satisfaction surveys (PSS) are increasingly used to engage consumers of healthcare systems. However, the value of PSS in informing infection prevention programs has not been evaluated. We sought to compare clinical audit findings on aseptic technique (AT) with patient-reported performance measures of AT at a large tertiary healthcare facility.


The study was performed in a day chemotherapy unit (May 2019) as part of a multi-strategy approach to improve AT practice observed during clinical auditing. A voluntary paper-based PSS were provided to patients attending the unit during the same month. A brief explanation of AT (hand hygiene, ‘scrub the hub’, and allowing hub to dry prior to accessing) was provided to patients. The patients were then asked: ‘When accessing your central line today, have nurses and doctors completed all above three points?’ Trained staff using standardised methods performed clinical auditing of hand hygiene and AT compliance throughout PSS circulation, and are continuing to do so.


In total, 26 patients completed PSS. Survey responses indicated a 92.3%  compliance with ‘scrub the hub’ and hand hygiene practices. However, 12 clinical audits conducted during and post the circulation of PSS demonstrated 50% compliance with ‘scrub the hub’, and 83.3% hand hygiene compliance prior to accessing a central line or drip line.


When compared to gold-standard clinical auditing, patient satisfaction surveys over-estimate the quality of aseptic technique practices. Although consumer engagement is important in implementing practice change, caution is required if PSS are used to identify practice gaps.


Megan is the Aseptic Technique Project Coordinator for Alfred Health in Melbourne, Victoria. She has a background in palliative care, emergency and infectious diseases nursing. Currently based in the Infection Prevention and Healthcare Epidemiology Unit, she is working towards a Masters in Public Health and Tropical Medicine. Away from work, Megan has a keen interest in apiary and environmental conservation.

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