Objectives We investigated the roles of patient carers in infection-related care on surgical wards in a South Indian hospital, from the perspective of healthcare workers (HCW), patients, and their carers.
Methods Ethnographic study including ward-round observations (138 hours) and face-to-face interviews (44 HCW, 6 patients/carers). Data (field notes, interview transcripts) were coded in NVivo 12 and thematically analysed. Data collection and analysis were iterative, recursive and continued until thematic saturation.
Results Carers have important, unrecognised roles. In the study site, institutional expectations are formalised in policies demanding a carer to always accompany inpatients. Such intense presence embeds families in the patient care environment, as demonstrated by their high engagement in direct personal (bathing patients) and clinical care (wound care). Carers actively participate in discussions on patient progress with HCWs, including therapeutic options. There is a misalignment between how carers are positioned by the organisation (through policy mandates, institutional practices, and HCWs expectations), and the role that they play in practice, resulting in their role, though indispensable, remaining unrecognised.
Conclusion Current models of patient and carer involvement in infection prevention and control (IPC) are poorly aligned with socio-cultural and contextual aspects of care. Culture-sensitive IPC policies which embrace the roles that carers play are urgently needed.