Rethinking risk communication in the hospital: infection prevention, risk perceptions, and lived experience

Abstract

ABSTRACT Background We conceptualize infection prevention and control (IPAC) as a form of risk communication in the hospital and examine how doctors and nurses interpret and adopt IPAC measures in the wards. Methods We conducted a 20-week ethnography in a Canadian hospital in which we observed doctors’ and nurses’ routines, infection prevention practices, and barriers they encountered when following IPAC guidelines. After the observation period, we conducted interviews with doctors and nurses to gauge their perceptions of risk and how they make IPAC decisions while working in the wards. Results Doctors and nurses perceive the hospital as a site of risk, and expressed this anxiety in disinfection routines and cleansing rituals. This risk prevention behaviour is mediated by situational and lived experience, and not expressed consistently. Doctors and nurses negotiate IPAC protocols with individual perceptions of risk, material limitations, and more pressing needs. Conclusion IPAC behaviour could be reinforced by improving risk communication in the hospital, first, by involving workers as stakeholders in managing the risk of infection, and second, by acknowledging various forms of risk knowledge, including embodied and situated experience, as well as material constraints. We recommend developing participatory models of risk communication that engage stakeholders in long-term dialogue, considering their risk perceptions, risk tolerance, and challenges to comply with guidelines; communicating IPAC measures as a way to protect patients and emphasizing personal risk for hospital workers; and conducting regular in-person training sessions to ensure that any concerns can be voiced.