scholarly journals Determinants of Good Adherence to Hand Hygiene Among Healthcare Workers Who Have Extensive Exposure to Hand Hygiene Campaigns

2007 ◽  
Vol 28 (11) ◽  
pp. 1267-1274 ◽  
Author(s):  
Hugo Sax ◽  
Ilker Uçkay ◽  
Hervé Richet ◽  
Benedetta Allegranzi ◽  
Didier Pittet

Objective.To quantify the different behavioral components of healthcare workers' motivation to comply with hand hygiene in a healthcare institution with a 10-year history of hand hygiene campaigning.Design.Cross-sectional study, by use of an anonymous, self-administered questionnaire.Setting.A 2,200-bed university teaching hospital.Participants.A stratified random sample of 2,961 medical and nursing staff.Results.A total of 1,042 questionnaires (35.2%) were returned. Of the respondents, 271 (26.0%) were physicians, 629 (60.4%) were nurses, and 141 (13.5%) were nursing assistants. Overall, 1,008 respondents provided information about sex; 718 (71.2%) of these were women. Respondents provided demographic information and data about various behavioral, normative, and control beliefs that determined their intentions with respect to performing hand hygiene. Among behavioral beliefs, the perception that healthcare-associated infections are severe for patients was highly ranked as a determinant of behavior by 331 (32.1%) of the respondents, and the perception that hand hygiene is effective at preventing these infections was ranked highly by 891 respondents (86.0%). Among normative beliefs, perceived social pressure from patients to perform hand hygiene was ranked highly by 760 respondents (73.7%), pressure from superiors was ranked highly by 687 (66.8%), pressure from colleagues was ranked highly by 596 (57.9%), and pressure from the person perceived to be most influential was ranked highly by 687 (68.8%). Among control beliefs, the perception that hand hygiene is relatively easy to perform was rated highly by 670 respondents (65.1%). High self-reported rates of adherence to hand hygiene (defined as performance of proper hand hygiene during 80% or more of hand hygiene opportunities) was independently associated with female sex, receipt of training in hand hygiene, participation in a previous hand hygiene campaign, peer pressure from colleagues, perceived good adherence by colleagues, and the perception that hand hygiene is relatively easy to perform.Conclusions.In a setting with a long tradition of hand hygiene campaigns, behavioral beliefs are strongly in favor of hand hygiene, but adherence is driven by peer pressure and the perception of high self-efficacy, rather than by reasoning about the impact of hand hygiene on patient safety. Female sex, training, and campaign exposure increased the likelihood of compliance with hand hygiene. This additional insight can help to shape future promotional activity.

Author(s):  
L. Vaillant ◽  
◽  
G. Birgand ◽  
M. Esposito-Farese ◽  
P. Astagneau ◽  
...  

Abstract Background Much effort has been made over the last two decades to educate and train healthcare professionals working on antimicrobial resistance in French hospitals. However, little has been done in France to assess perceptions, attitudes and knowledge regarding multidrug resistant organisms (MDROs) and, more globally, these have never been evaluated in a large-scale population of medical and non-medical healthcare workers (HCWs). Our aim was to explore awareness among HCWs by evaluating their knowledge of MDROs and the associated control measures, by comparing perceptions between professional categories and by studying the impact of training and health beliefs. Methods A multicentre cross-sectional study was conducted in 58 randomly selected French healthcare facilities with questionnaires including professional and demographic characteristics, and knowledge and perception of MDRO transmission and control. A knowledge score was calculated and used in a logistic regression analysis to identify factors associated with higher knowledge of MDROs, and the association between knowledge and perception. Results Between June 2014 and March 2016, 8716/11,753 (participation rate, 74%) questionnaires were completed. The mean knowledge score was 4.7/8 (SD: 1.3) and 3.6/8 (SD: 1.4) in medical and non-medical HCWs, respectively. Five variables were positively associated with higher knowledge: working in a university hospital (adjusted odds ratio, 1.41, 95% CI 1.16–1.70); age classes 26–35 years (1.43, 1.23–1.6) and 36–45 years (1.19, 1.01–1.40); medical professional status (3.7, 3.09–4.44), working in an intensive care unit (1.28, 1.06–1.55), and having been trained on control of antimicrobial resistance (1.31, 1.16–1.48). After adjustment for these variables, greater knowledge was significantly associated with four cognitive factors: perceived susceptibility, attitude toward hand hygiene, self-efficacy, and motivation. Conclusions We found a low level of MDRO awareness and knowledge of associated control measures among French HCWs. Training on hand hygiene and measures to control MDRO spread may be helpful in shaping beliefs and perceptions on MDRO control among other possible associated factors. Messages should be tailored to professional status and their perception. Other approaches should be designed, with more effective methods of training and cognitive interventions. Trial registration Clinical Trials.gov NCT02265471. Registered 16 October 2014 - Retrospectively registered.


2020 ◽  
Vol 41 (S1) ◽  
pp. s498-s499
Author(s):  
Isata Adama Bangura

Background: Hand hygiene (HH) is considered a primary measure necessary for reducing healthcare-associated infections (HAIs). Despite its significance, the lack of compliance among healthcare workers continues to be a problem throughout the world. The Ebola outbreak in our country has accelerated efforts to strengthen the health system in Sierra Leone. The WHO multimodal strategy on HH is an integral approach to the reduction of HAIs. Objectives: We sought to improve HH compliance among healthcare workers, to maintain a culture of safety in the healthcare facility, and to implement evidence-based practices for improved patient outcomes. Methods: A WHO multimodal strategy for direct observation of HH was adapted. We observed clinical staff (doctors, nurses and community health officers) in the intensive care unit (ICU), resuscitation ward (Resus) and emergency room (ER) from August to September 2019. A 4-day training session was conducted in 3 weeks. Provision of locally produced alcohol-based hand rub (ABHR), soap, and water emphasize the importance of HH. HH reminders were posted in all clinical areas. Healthcare worker knowledge about HH was assessed before and after the intervention. Results: We observed 1,535 HH opportunities, and only 706 HH actions were performed. Locally produced ABHR was used in 470 HH actions. Handwashing with soap and water was used in the remaining HH actions. Baseline compliance was 36% and increased to 50% in the first and second months. Healthcare worker knowledge scores at the baseline averaged 25% and increased to 65% after 2 months. HH compliance was highest in the ICU (44%), followed by the emergency ward (30%). The resuscitation ward had the lowest compliance (26%). Compliance among doctors was 32%, nurses 46%, and CHOs 22%. Conclusions: Promotion of HH is feasible and attainable and can be sustained in a resource- constrained setting using a multimodal improvement strategy. The local production, availability, and use of ABHR have significantly increased HH compliance. However, absolute compliance remains low, and a strong commitment by hospital management and healthcare workers may be needed for further improvement.Disclosures:If I am providing recommendations involving clinical medicine, they will be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to will conform to the generally accepted standard of experimental design, data collection and analysis.DisagreeIf I am presenting research funded by a commercial company, the information presented will be based on generally accepted scientific principals and methods, and will not promote the commercial interest of the funding company.DisagreeIf I am discussing specific healthcare products or services, I will use generic names to extent possible. If I need to use trade names, I will use trade names from several companies when available, and not just trade names from any single company.DisagreeI have disclosed all relevant financial relationships and I will disclose this information to learners.:DisagreeIsata Adama BanguraFunding: None


Author(s):  
Ognjen Brborović ◽  
Hana Brborović ◽  
Iskra Alexandra Nola ◽  
Milan Milošević

Introduction: Every procedure in healthcare carries a certain degree of inherent unsafety resulting from problems in practice, which might lead to a healthcare adverse event (HAE). It is very important, and even mandatory, to report HAE. The point of HAE reporting is not to blame the person, but to learn from the HAE in order to prevent future HAEs. Study question: Our aim was to examine the prevalence and the impact of culture of blame on health workers’ health. Methods: A cross-sectional study on healthcare workers at two Croatian hospitals was conducted using the Hospital Survey on Patient Safety Culture (PSC). Results: The majority of PSC dimensions in both hospitals were high. Among the dimensions, Hospital Handoffs and Transitions and Overall Perceptions of Safety had the highest values. The Nonpunitive Response to Error dimension had low values, indicating the ongoing culture of blame. The Staffing dimension had low values, indicating the ongoing shortage of doctors and nurses. Discussion: We found inconsistencies between a single-item measure and PSC dimensions. It was expected that Frequency of Events Reported (PSC dimension) relates to Number of Events Reported (single-item measure). However, in our study, the relations between these pairs of measures were different between hospitals. Our results indicate the ongoing culture of blame. Healthcare workers do not report HAE because they fear they will be punished by management or by law.


2020 ◽  
pp. postgradmedj-2020-139150 ◽  
Author(s):  
Ramanathan Swaminathan ◽  
Bimantha Perera Mukundadura ◽  
Shashi Prasad

BackgroundThe COVID-19 pandemic has necessitated the use of enhanced personal protective equipment (PPE) in healthcare workers in patient-facing roles. We describe the impact on the physical and mental well-being of healthcare professionals who use enhanced PPE consistently.MethodsWe conducted a single-centre, cross-sectional study among healthcare professionals who use enhanced PPE. A web-based questionnaire was disseminated to evaluate the effects on individuals’ physical and mental well-being. Physical and mental impact was assessed through a visual analogue scale.ResultsProspective analysis of the views of 72 respondents is reported. 63.9% were women and 36.1% were men. Physical impact included exhaustion, headache, skin changes, breathlessness and a negative impact on vision. Communication difficulties, somnolence, negative impact on overall performance and difficulties in using surgical instrumentation were reported.ConclusionOur study demonstrates the undeniable negative impact on the front-line healthcare workers using enhanced PPE and lays the ground for larger multicentric assessments given for it to potentially be the norm for the foreseeable future.


2010 ◽  
Vol 31 (11) ◽  
pp. 1170-1176 ◽  
Author(s):  
Dominik Mertz ◽  
Nancy Dafoe ◽  
Stephen D. Walter ◽  
Kevin Brazil ◽  
Mark Loeb

Objectives.Adherence to hand hygiene among healthcare workers (HCWs) is widely believed to be a key factor in reducing the spread of healthcare-associated infection. The objective of this study was to evaluate the impact of a multifaceted intervention to increase rates of adherence to hand hygiene among HCWs and to assess the effect on the incidence of hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) colonization.Design.Cluster-randomized controlled trial.Setting.Thirty hospital units in 3 tertiary care hospitals in Hamilton, Ontario, Canada.Intervention.After a 3-month baseline period of data collection, 15 units were randomly assigned to the intervention arm (with performance feedback, small-group teaching seminars, and posters) and 15 units to usual practice. Hand hygiene was observed during randomly selected 15-minute periods on each unit, and the incidence of MRSA colonization was measured using weekly surveillance specimens from June 2007 through May 2008.Results.We found that 3,812 (48.2%) of 7,901 opportunities for hand hygiene in the intervention group resulted in adherence, compared with 3,205 (42.6%) of 7,526 opportunities in the control group (P < .001; independent t test). There was no reduction in the incidence of hospital-acquired MRSA colonization in the intervention group.Conclusion.Among HCWs in Ontario tertiary care hospitals, the rate of adherence to hand hygiene had a statistically significant increase of 6% with a multifaceted intervention, but the incidence of MRSA colonization was not reduced.


2018 ◽  
Vol 5 (1) ◽  
pp. 90-95
Author(s):  
Ajay Kumar Rajbhandari ◽  
Reshu Agrawal Sagtani ◽  
Kedar Prasad Baral

Introductions: Transmission of healthcare associated infections through contaminated hands of healthcare workers are common. This study was designed to explore the existing compliance of hand hygiene among the healthcare workers workings in different level of health care centers of Makwanpur district of Nepal. Methods: This was a cross sectional observational study conducted in Makwanpur district, Nepal, during 2015. Healthcare workers from nine healthcare centers were selected randomly for the study. Standard observation checklists and World Health Organization guidelines on hand hygiene were used to assess the compliance of hand hygiene during patient care. Results: There were 74 participants. Overall compliance for hand washing was 24.25% (range 19.63 to 45.56). Complete steps of hand washing were performed by 38.3% of health care workers. The factors associated for noncompliance were lack of time (29.3%), example set by seniors (20%), absence or inadequate institution protocol (20%) and unfavourable health care setting (> 20%). Conclusions: Overall hand washing compliance rate amongst the healthcare workers in rural health facilities of Nepal were low (24.25%).


2007 ◽  
Vol 28 (3) ◽  
pp. 365-367 ◽  
Author(s):  
Solange L. Santana ◽  
Guilherme H. C. Furtado ◽  
Ana Paula Coutinho ◽  
Eduardo A. S. Medeiros

We analyzed the impact of introducing an alcohol-based hand gel and an educational program on hand hygiene adherence among healthcare workers in an intensive care unit. Adherence to hand hygiene was significantly higher after the intervention for the night shift work period (P = .001), among nursing assistants (P = .001), among nurses (P = .007) on weekend days (P = .016), and for invasive procedures (P = .012).


2009 ◽  
Vol 30 (9) ◽  
pp. 830-839 ◽  
Author(s):  
Yves Longtin ◽  
Hugo Sax ◽  
Benedetta Allegranzi ◽  
Stéphane Hugonnet ◽  
Didier Pittet

Background.Research suggests that patients could improve healthcare workers' compliance with hand hygiene recommendations by reminding them to cleanse their hands.Objective.To assess patients' perceptions of a patient-participation program to improve healthcare workers' compliance with hand hygiene.Design.Cross-sectional survey of patient knowledge and perceptions of healthcare-associated infections, hand hygiene, and patient participation, defined as the active involvement of patients in various aspects of their health care.Setting.Large Swiss teaching hospital.Results.Of 194 patients who participated, most responded that they would not feel comfortable asking a nurse (148 respondents [76%]) or a physician (150 [77%]) to perform hand hygiene, and 57 (29%) believed that this would help prevent healthcare-associated infections. In contrast, an explicit invitation from a healthcare worker to ask about hand hygiene doubled the intention to ask a nurse (from 34% to 83% of respondents; P < .001) and to ask a physician (from 30% to 78%; P < .001). In multivariate analysis, being nonreligious, having an expansive personality, being concerned about healthcare-associated infections, and believing that patient participation would prevent healthcare-associated infections were associated with the intention to ask a nurse or a physician to perform hand hygiene (P < .05). Being of Jewish, Eastern Orthodox, or Buddhist faith was associated also with increased intention to ask a nurse (P < .05), compared with being of Christian faith.Conclusions.This study identifies several sociodemographic characteristics associated with the intention to ask nurses and physicians about hand hygiene and underscores the importance of a direct invitation from healthcare workers to increase patient participation and foster patient empowerment. These findings could guide the development of future hand hygiene-promotion strategies.


Sign in / Sign up

Export Citation Format

Share Document