Data extraction table. Characteristics of included studies
| Reference | Country | Study aims | Study design | Study participants healthcare professional (HCP):including nurses, doctors, and allied health P: patient and caregivers, family | Key findings | Sample size |
| Hill et al19 | USA | Assess patient (P) and healthcare professional (HCP) perspectives on methicillin-resistant Staphylococcus aureus (MRSA): a qualitative assessment of knowledge, beliefs, and behaviour, with an ultimate goal of developing patient educational materials that address the issues unique to SCI/D. | Cross-sectional observational design and focus groups. | HCP: physicians and nurses P: eight veterans with | HCP and P identified gaps in general MRSA knowledge, gaps in knowledge of good hand hygiene practices and of required frequency of hand hygiene and barriers to educating P with SCI/D during inpatient stays. Recommendation: Development of ‘easy-to-understand message delivered in a consistent and engaging manner that also provided the patient with a clear way to meaningfully engage with their providers about MRSA prevention behaviours’ (p.89). | Thirty-three HCP and eight P. |
| McGuckin and Govednik6 | USA | To review the current literature on patient willingness to be empowered, barriers to empowerment and hand hygiene programmes that include patient empowerment and hand hygiene improvement. | Literature review | HCP: not specified other professions beyond medicine and nursing P: mention to patient and family member’s involvement. | ‘There is ongoing support from patients that they are willing to be empowered. There is a need to develop programmes that empower both healthcare workers and patients so that they become more comfortable in their roles’ (p.191). | Two studies: WHO HH guidelines and a companion review, ‘Patient Empowerment and Multimodal Hand Hygiene Promotion: a WineWin Strategy’. |
| See et al28 | USA | Explore the attitudes and preferences of patients on haemodialysis regarding educating and engaging such patients in BSI prevention. | Focus groups, with patient ambassadors from Dialysis Patient Citizens. | P: patient ambassadors from Dialysis Patient Citizens. | Patients reported that education on infection prevention should begin early in the process of dialysis and that patients should be actively engaged as partners in infection prevention. | Twelve P |
| Loveday et al27 | UK | To review and update the evidence base for making infection prevention control and recommendations. | Systematic review | HCP (not specified), P | Importance of patients and carers’s education about hand hygiene and their role in maintaining standards of healthcare workers’ hand hygiene. | 68 studies |
| Wyer et al22 | Australia | Explore patients’ perspectives on infection prevention and control (IPC). | Video-reflexive ethnography | P | ‘Viewing and discussing video footage of clinical care enabled patients to become articulate about infection risks, and to identify their own roles in reducing transmission. The reflexive process engendered closer scrutiny and a more critical attitude to infection control that increased patients' sense of agency’ (p.1). | 14 P |
| Seale et al21 | Australia | Examine the level of awareness towards patient empowerment, previous experiences with campaigns, and degree of acceptance toward the introduction of a new empowerment programme focused on engaging patients around infection control strategies. | Semistructured interviews | P | ‘Just over half of the participants were highly willing to assist with infection control strategies. Participants were significantly more likely to be willing to ask a doctor or nurse a factual question then a challenging question’ (p.447). ‘Patients are not receiving sufficient information about HCAIs and infection control, and they are not being encouraged to take a role’ (p.452). | 60 P |
| Davis et al11 | UK | Systematic review of the effectiveness of strategies to encourage patients to remind HCPs about their hand hygiene. | Scoping review | HCP (not specified, but most studies involving nurses and physicians), P | The strategies (videos, videos and leaflet) showed promise in helping to increase patients’ intentions and/or involvement in reminding HCPs about their HH. | 28 studies |
| Seale et al7 | Australia | Examine the level of awareness towards patient empowerment, previous experiences with campaigns and degree of acceptance towards the introduction of a new empowerment programme focused on engaging patients around infection control strategies. | Semistructured interviews | HCP (nurses, doctors and allied health staff). | Patient engagement remains an underused method. By extending the concept of patient empowerment to a range of infection prevention opportunities, the positive impact of this intervention will not only extend to the patient but to the system itself. | 29 HCP |
| Miller et al26 | Australia | Identifying and integrating patient and caregiver perspectives for clinical practice guidelines on the screening and management of infectious micro-organisms in haemodialysis units. | Facilitated workshop | P (patients and family members). | Integrating patient and caregiver perspectives can help to improve the relevance of guidelines to enhance quality of care, patient experiences, and health and psychosocial outcomes. | 11 P (8 patients and 3 family members). |
| Tartari et al18 | Netherlands | Identify basic and pragmatic recommendations for patients to be empowered by healthcare workers to seek information at an early stage and actively engage through their surgical journey. | Expert panel | HCP (not specified) | Nine pragmatic recommendations for the involvement of surgical patient in IPC are presented here, including a practice brief in the form of a patient information leaflet. | Five key IPC experts and infectious disease specialists, with a special interest in surgical site infections formed the expert panel. |
| Cheng et al20 | China | Report a patient empowerment programme in hand hygiene promotion. | Quasi-experimental | HCP (nurses, doctors, and allied health staff) P | ‘A positive response from the healthcare workers was reported in 70 (93.3%) of 75 patients who reminded healthcare workers to clean hands as part of the empowerment programme. A significant increase in volume of alcohol-based handrub consumption was observed during the intervention period compared with baseline’ (p 562). | 167 P 114 HCP |
| Dadich and Wyer5 | Australia | Examine patient involvement in healthcare-associated infection (HAI) research. | Lexical review | HCP (not specified), P | ‘Patient involvement is largely limited to recruitment to HAI studies rather than extended to patient involvement in research design, implementation, analysis, and/or dissemination’. (p.1). | 148 studies |
| Alzyood et al9 | UK | To provide an understanding from the perspective of HCPs on patient involvement in improving hand hygiene compliance of clinical staff. | Integrative review | HCP (nurses, doctors, and allied health staff), P | ‘Patient involvement was related to how patients asked and how HCPs responded to being asked. Simple messages promoting patient involvement may lead to complex reactions in both patients and HCPs. It is unclear, yet how patients and staff react to such messages in clinical practice’ (p.1329). | 19 papers |
| Butenko et al 10 | Australia | To determine the best evidence available in relation to the experiences of the patient partnering with HCPs for hand hygiene compliance. | Systematic review | HCP (medical and nursing staff), P | ‘Organisational structures enable partnering between HCPs and patients do not fully support this partnership. Patients have different level of knowledge and balance partnering in HH against possible detrimental impacts on the caring relationship provided by HCP’ (p.1646). | Three papers |
BSI, bloodstream infections; HH, hand dygiene; SCI/D, spinal cord injury and disorders.