Improving healthcare worker adherence to the use of transmission-based precautions through application of human factors design: a prospective multi-centre study.

A key component of transmission-based precautions (TBPs) is the use of personal protective equipment (PPE) but healthcare worker (HCW) adherence remains suboptimal. A human factors-based intervention was implemented to improve adherence to TBPs including (i) improved signage, (ii) standardized placement of signage, (iii) introduction of a mask with integrated face shield, and (iv) improvement in PPE availability. Donning of the correct PPE by HCWs improved significantly (79.7 vs 56.4%; P < 0.001). This approach may be more effective than education alone, but further study is required to determine sustainability and subsequent impact on transmission of healthcare-associated infections.

A hidden client group? Communication impairment in hospice patients.

Retrospective research has identified communication impairment in over a quarter of hospice patients (Jackson et al. 1996) but this field has not been investigated using speech and language therapy assessments. The present study assessed a sample of 12 hospice patients using tests of verbal learning and recall, word-finding, sentence comprehension and motor speech. Eleven patients experienced difficulties in one or more areas of assessment. Possible reasons are discussed, including the effects of patients' illness and treatment and changes in mood or cognitive functioning. A role for speech and language therapy is proposed, in terms of assessment, advice and training. Further research is suggested to help establish the extent of impairment and define a role for speech and language therapy.