Major article
“Recognizing rapport”: Health professionals’ lived experience of caring for patients under transmission-based precautions in an Australian health care setting

https://doi.org/10.1016/j.ajic.2013.05.022Get rights and content

Background

Preventing health care–associated infections is essential to the safety and quality of health care. Although patients’ experience of care under isolation is well established, little is known of health care workers' experiences when providing such care. This study explored the health professionals; lived experience of caring for patients under transmission-based precautions.

Methods

Interpretive phenomenology was used to examine 12 health care professionals' lived experience of providing care under transmission-based precautions in 3 health care facilities in Australia. Data were obtained from in-depth interviews and observations of health professionals.

Findings

The essential phenomena of “recognizing rapport” represented the health professionals' lived experience. Three themes emerged starting with (1) relationships with others, their rapport and communication with patients, patients' families and visitors, and colleagues. These relationships are influenced by (2) barriers to practice, such as personal level of comfort when wearing personal protective equipment, physical limitations of the environment, and management of workload and resources. Such barriers influence (3) patient outcomes, namely the quality of the care provided and adverse events.

Conclusion

In the context of caring for patients under transmission-based precautions, the relationships between health professionals and their patients are critical to the quality and safety of health care with respect to infection prevention and control.

Section snippets

Study design

This study used an interpretive phenomenology approach derived from the hermeneutic philosophy of Heidegger.12 This approach enabled examination of the phenomena from the health professional's perspective, providing insight into the meaning of those lived experiences rather than simply describing the experiences of caring for patients under transmission-based precautions. The methodology was a good conceptual fit because it took into account a pre-understanding of their workplace, the culture,

Findings

For the participants in this study, the lived experience of caring for patients under transmission-based precautions, revealed an overall phenomena of “recognizing rapport” and 3 key themes: (1) relationships, (2) barriers to practice, and (3) patient outcomes. These themes reflect how the participants understand and interpret their experience of caring for patients under transmission-based precautions.

The phenomenon of recognizing rapport encapsulates relationships with patients, colleagues,

Discussion

Research shows that transmission-based precautions and comparable infection control practices have a major effect on the psychological well-being of patients.6, 18, 19 For example, the use of a gown and a pair of gloves may be a barrier to providing health care. The present study shows that health professionals are conscious of such effects and actively search for ways to develop patient rapport. Participants also reported concerns that the physical barriers of PPE and personal spectacles carry

Conclusion

Health professionals are pivotal to patient safety and the quality of health care. The findings of this study reinforce the interdependence of patients and health professionals in assuring safe, quality health care. The data connect patients' and health professionals’ perspectives with respect to health care–associated infections, and add to the evidence base of contemporary infection prevention and control practice. They emphasize the importance of building good rapport and well-balanced

Acknowledgment

The authors thank the participants for their time and contributions that enabled this study.

References (20)

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This research was funded in part by the University School of Nursing and Midwifery through a postgraduate student research grant.

Conflict of interest: None to report.

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Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.