Influencing Perceptions of Risk: Staff & Patient Perspectives on Infection Prevention

1. Professor Kay Currie on behalf of: Staff & patient perspectives programme The ‘SHIP’ Research Group (Safeguarding Health through Infection Prevention) Scottish HAI Prevention Institute (SHAIPI) Consortium From bugs to behaviours: influencing perceptions of risk

2. Overview of presentation: Evolution of our staff & patient perspectives programme: Increasing sophistication in our use of social science theories to explain findings Emerging impact from our work Ongoing studies and future plans

3. 2016 SHAIPI Review: SHAIPI Work-stream 3: Building and connecting our research to national policy and internationally

4. Examples from patient & staff experience programme:

6. HPS Norovirus Outbreak Guidance Season Preparedness, control measures & practical considerations for optimal patient safety and service continuation in hospitals Chief Nursing Officer Fiona McQueen added: “There may also be times when hospitals or care homes will ask you not to visit during an outbreak to prevent further spread of the virus. During the winter season please check with the hospital or care home before you go to visit. Temporarily suspending visiting to affected wards allows infection prevention and control teams to monitor the situation and also reduce, as much as possible, the chance of norovirus being passed onto a relative or loved one or transferred between patients and visitors”. [SGHD Norovirus Advice, 26th November 2015]

7. Application of Social Science Theoretical Frameworks: Sociological perspective (NPT) • examine the work that takes place within organisations to embed screening as an intervention Psychological perspective (TDF) • explore factors affecting the individuals’ decision to act in specific situations

8. K Currie, C King, K McAloney, N Roberts, J MacDonald, A Dickson, P Flowers, L Price. GCU SHIP Research Group The Acceptability of CPE Screening: A mixed methods study of staff and the general publics’ views • Study funded by Health Protection Scotland & • The Scottish Infection Research Network • There are no Conflicts of Interest to disclose

9. Summary Findings demonstrate: The Scottish public find CPE screening and the management of colonisation acceptable Knowledge (or lack thereof) of AMR is a key predicator of the acceptability of CPE Screening Social influences are also important.

10. Kay Currie, on behalf of C King, K McAloney, N Roberts, J MacDonald, A Dickson, P Flowers, L Price, J Reilly. GCU SHIP Research Group ‘Make doing the right thing easy!’ (or, overcoming barriers to staff compliance with MDRO HAI screening) • Study funded by Health Protection Scotland & • The Scottish Infection Research Network • No conflicts of interest

11. Summary MDRO screening is a fundamental aspect of IPC Implementing MDRO screening in clinical areas is a complex intervention Individual attitudes & beliefs, group dynamics and organisational contexts all influence intentions & actual / self-reported MDRO screening behaviours Compliance with screening is more likely when • screening is highly routinized in practice • Staff believe the consequences of MDROs are severe • Staff have been informed of hospital screening policy • Staff have feedback on their screening compliance rates Compliance is likely to be lower when • acuity and patient flow pressures mean screening is perceived as less of a priority

12. AMR BESH Project

13. Professor Kay Currie, Dr Caroline King, Lynne Melone, Sally Stewart, Prof ArjaHolopainen, Prof Alex M. Clark, Prof Jacqui Reilly Study part funded by SHAIPI consortium Understanding the patient experience of healthcare associated infection: A qualitative systematic review

14. Meta-synthesis process (Noblet & Hare, 1988)

15. Summary The impact of different HAIs may vary; however, there are many similarities in the experience recounted by patients. The bio-sociocultural context of contagion was graphically expressed, with potential impact on social relationships and professional interactions highlighted. Further research to investigate contemporary patient experience in an era of antimicrobial resistance is warranted.

16. The ‘One Health’ approach to AMR: our Behavioural Insights research programme Applied principles from behavioural and implementation science to explore understanding of AMR and stewardship from multiple stakeholder perspectives. Participants included: cross-sector experts within AMR; hospital based practitioners; veterinarians; farmers; food industry; pet owners; parents; and the general public.

17. Synthesis of Key Findings across all studies: Lack of clarity / understanding of AMR and ‘One Health’ approaches across sectors Challenges in inter-sectorial communication and governance Unhelpful reciprocal distribution of culpability and the diffusion of responsibility (blaming others) Resource constraints and structures to focus on the systems affecting AMR and stewardship Need to focus public health and behaviour change messages on specific populations and behaviours

18. Ongoing – some of our PhD students projects

19. In conclusion: We have used robust social science theories and methods to explore staff and patient perspectives on applied IPC Our work has focused on specific IPC interventions, as well as more global ‘One Health’ approaches to understanding context and behaviours related to AMR We have a vibrant PhD student group working in this area Our findings have been accepted and adopted by Health Protection Scotland to develop ‘Best Practice’ recommendations

20. Thank you. Any questions? k.currie@gcu.ac.uk @curriekay