UAB Synopsis, Vol. 27, No. 17, May 5, 2008
Doctors and nurses may need to actively encourage patients to ask questions about safety issues related to their care, such as handwashing, according to a recent study that a UAB infection control specialist says is consistent with his experience.
The study of surgery patients in an inner-London hospital, published in the journal Quality and Safety in Health Care (2008;17:90-96), concluded that patients are more willing to challenge nurses than doctors about safety issues related to their care. It also showed that patients were far more likely to ask factual questions of all health care professionals, such as the length of their hospital stay, than they were to pose questions that might be perceived as challenging clinical abilities, such as whether health care professionals had washed their hands.
When doctors encouraged patients to ask difficult questions, the patients were more willing to quiz both sets of professionals on safety and quality issues.
“In general, patients do not ask enough questions about tests they are to have or treatments they are to receive,” Health System Infection Control Committee Chair Alan M. Stamm, MD, says. “If patients asked enough questions, we would not need informed consent. For major procedures, we obtain consent by telling them what they should have asked about spontaneously.”
Patient Prompts Essential
Dr. Stamm, professor of medicine, Division of General Internal Medicine, says the success of UAB Hospital’s handwashing program, Partners in Your Care, relies on patient prompts of health care workers (“Have you washed your hands?”). “Initial instruction by a nurse may not make a patient feel comfortable questioning their physician about hand hygiene – it may require both physician and nurse encouragement,” he says.
“More outspoken, questioning patients would help us avoid identification errors, medication and transfusion errors, wrong patient procedures, and wrong site surgeries,” he says. “We need to encourage greater involvement and less passivity in our patients.”
In the study, women were more willing than men to ask questions. Men with low levels of education and those who were unemployed seemed to be least willing to ask questions.