• Infection Prevention Signage

Using signs to improve Infection Prevention: Do they work?

For more than twenty years1 hospitals have used signs to guide staff and visitors on how to avoid exposure to various infections. Signs located immediately outside a patient’s room are commonly used to indicate specific measures needed before entering2. In the general community signs are also used to educate the public and to promote and guide behaviours which reduce spread of infectious disease. Nonetheless, researchers and casual observers in both healthcare and community settings report widespread disregard for these educational and promotional messages and warnings. To improve the impact of infection prevention signs it’s useful to consider when they work.

When you need to go to the bathroom, you’ll seek out signs that indicate one is nearby. When you’re in danger, you rely on signs to keep you safe from that danger. Road signs indicating “one way only” or “no entry oncoming traffic” are examples of how much we trust what signs tell us.  Signs that warn of inconvenience, punishment, fines or loss of rights or privileges can also deter or encourage certain behaviours. Recent Australian non-smoking campaigns have used gross and confronting images of damaged body parts and dying smokers to promote quit programs. Early indications suggest this approach is reducing cigarette consumption.

To date only soft messaging has been used on most signs about infectious diseases and infection control. Simple illustrations and complex healthcare jargon have been the hallmarks of our signs. Naively we have assumed readers trust us, share our beliefs and values about infectious disease and that they understand our message and will commit to it. Additionally in hospitals we have often placed our isolation signs slightly out of view or developed them in cryptic form so as to ensure we respect the patient’s rights to privacy. We do it also to avoid invoking unnecessary concern or hysteria among non-clinical staff, family or visitors. Signs used in community settings are often attention-grabbing but scientifically incorrect which may reflect their design by advertising gurus, visual artists or other non-clinicians.

As the human brain is increasingly overwhelmed with readily-accessible and ever-available information, infection prevention messaging becomes even more important. In hospitals our signs compete for the best piece of real estate. It is common to see hospital entrances and walls of wards plastered in signs about other equally significant clinical, human resource or service related announcements. Developing, designing and displaying an attention grabbing infection prevention sign is complex. Making sure that a sign changes behaviour and reduces transmission of infectious disease is an elusive goal. Many social media applications now provide us with attractive, far-reaching alternative platforms from which to convey our message. Regardless if we want our infection prevention messages to have impact there are general principles of messaging and communication we must apply. The following list provides a few examples of these principles which we hope you will consider when you next write or read an infection prevention message.

  1. Avoid confusing, ambiguous and easily misinterpreted language, terms and meaning
  2. Don’t make improbable or unbelievable statements
  3. If your sign evokes behaviours and actions contrary to what it is recommending – the sign is not working and needs to be reviewed
  4. Signs are only useful if they resonate with the reader
  5. Don’t place signs in places where they are obstructed
  6. Make sure the fonts used are readable and that images are consistent with the message of the text.

We have amassed an impressive collection of infection prevention signs from hospital and community settings around the world. Some we’ve developed others we’ve observed. Please feel free to share, re-pin and use these signs in your own efforts to make our world safer. You can access our collection on our Pinterest site by clicking through to the Signs Board.

1Soule BM. Universal Precations: Policies, Procedures, and Resources, Gina Pugliese, Patricia Lynch, Marguerite Jackson (Eds.). American Hospital Publishing, Chicago (1990). American Journal of Infection Control. 1992;20(2):85-86.

2Bessesen MT, Lopez K, Guerin K, et al. Comparison of control strategies for methicillin-resistant Staphylococcus aureus. American Journal of Infection Control. (0).

About the Author:

As Executive Director of Infection Control Plus Pty Ltd, Cathryn Murphy PhD provides independent consulting services to a range of clinical, public policy and commercial clients throughout the world.