Open Access Highly Accessed Research article

Communication interventions to improve adherence to infection control precautions: a randomised crossover trial

Mei-Sing Ong1*, Farah Magrabi1, Jeffrey Post23, Sarah Morris4, Johanna Westbrook5, Wayne Wobcke6, Ross Calcroft7 and Enrico Coiera1

Author Affiliations

1 Centre for Health Informatics, University of New South Wales, Sydney, Australia

2 Department of Infectious Diseases, Prince of Wales Hospital, Sydney, Australia

3 Prince of Wales Clinical School, University of New South Wales, Sydney, Australia

4 Department of Medical Imaging, Prince of Wales Hospital, Sydney, Australia

5 Centre for Health Systems and Safety Research, University of New South Wales, Sydney, Australia

6 School of Computer Science and Engineering, University of New South Wales, Sydney, Australia

7 Intensive Care Unit, Liverpool Hospital, Sydney, Australia

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BMC Infectious Diseases 2013, 13:72  doi:10.1186/1471-2334-13-72

Published: 6 February 2013



Ineffective communication of infection control requirements during transitions of care is a potential cause of non-compliance with infection control precautions by healthcare personnel. In this study, interventions to enhance communication during inpatient transfers between wards and radiology were implemented, in the attempt to improve adherence to precautions during transfers.


Two interventions were implemented, comprising (i) a pre-transfer checklist used by radiology porters to confirm a patient’s infectious status; (ii) a coloured cue to highlight written infectious status information in the transfer form. The effectiveness of the interventions in promoting adherence to standard precautions by radiology porters when transporting infectious patients was evaluated using a randomised crossover trial at a teaching hospital in Australia.


300 transfers were observed over a period of 4 months. Compliance with infection control precautions in the intervention groups was significantly improved relative to the control group (p < 0.01). Adherence rate in the control group was 38%. Applying the coloured cue resulted in a compliance rate of 73%. The pre-transfer checklist intervention achieved a comparable compliance rate of 71%. When both interventions were applied, a compliance rate of 74% was attained. Acceptability of the coloured cue was high, but adherence to the checklist was low (40%).


Simple measures to enhance communication through the provision of a checklist and the use a coloured cue brought about significant improvement in compliance with infection control precautions by transport personnel during inpatient transfers. The study underscores the importance of effective communication in ensuring compliance with infection control precautions during transitions of care.