Infection prevention as a shared responsibility: Improving the patient experience during contact isolation

Healthcare-Associated Infections (HAI) can occur when microorganisms spread between hospitalized patients. To prevent highly contagious or resistant microorganisms from spreading from one patient to the other, isolation precautions such as contact isolation are applied when patients carry such a microorganism. The first part of this theses describes how contact isolation has a negative impact on well-being on patients. The experience during contact isolation can improve by establishing an open healthcare environment and providing information during the full isolation process. Collective action theories appear to have potential to be applied to the context of infection prevention. The contribution of patients, healthcare providers and visitors to infection prevention can be stimulated by increasing community feeling, establishing connections between individuals and providing information about past actions of other individuals. Context research has been conducted in VUmc and results on the current patient experience are gathered in a patient journey. Conclusions on the current patient experience during isolation are as following: 1. a shattered sense of responsibility amongst different actors 2. different patient persona’s experience contact isolation differently 3. a difference in experience and behaviour of first time isolation patients and readmitted patients. To improve the patient experience during contact isolation, the second part of this thesis focusses on creating a solution. By combining the conclusions and the literature, a design vision is formulated: I want to increase the feeling of community amongst all actors in the contact isolation process, so that all individuals experience a sense of shared responsibility towards infection prevention in VUmc. A first step towards the design vision is created with the guidance of the following design goal: I want patients to develop a favourable attitude towards contact isolation during the first time into contact isolation by providing a tool that lets them experience partnership with healthcare providers and visitors in contributing to the safety of others. Building from the patient journey and the design goal, a solution, Bundel, is proposed. It aims to increase a feeling of shared responsibility amongst the different involved actors and stimulated collaboration between individual. Bundel provides necessary and desired information to patients and visitors at fitting times. The first time into contact isolation is slowed down by spreading the information a patient needs and wants over the isolation process. By providing all the information to patients from the start of the isolation process, they can discover the necessary information they are looking for when they are ready. In addition, visitors are increasingly involved in infection prevention, because the design makes their involvement necessary them. Bundel thereby stimulates them to personally find the necessary information. For nurses and other healthcare providers, Bundel facilitates the transfer from a ‘controller and corrector’ to a ‘guide and facilitator’ towards patients and visitors. Therefore, responsibility that currently mainly lies with the nurse, shifts to a more equally shared responsibility amongst all actors.