A nursing practice problem: Failure to observe aseptic technique

McLane, Carolyn; Chenelly, Sandra; Sylwestrak, Mary Lou; Kirchhoff, Karin T.

doi:10.1016/0196-6553(83)90078-0

Cited by 38 publications

(12 citation statements)

References 2 publications

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“…Respondents can also have unrealistic estimations of their own behaviour [5,11,12], as shown by the discrepancy between the HCWs' perceived adherence to hand hygiene in the hospital and the reported personal adherence to hand hygiene (76.8% vs. 84.6%; p < 0.0001). Moreover, HCWs can believe that they wash their hands when necessary even when observations indicate otherwise [30,31]. …”

Section: Discussionmentioning

confidence: 99%

Healthcare workers' and parents' perceptions of measures for improving adherence to hand-hygiene

et al. 2011

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BackgroundThis study was conducted to evaluate perceptions of healthcare workers (HCW) and parents regarding hand-hygiene and effectiveness of measures for increasing hand-hygiene adherence, in a children's hospital in Italy.MethodsA cross-sectional study was performed from 5 to 13 July 2010, using two self-administered anonymous questionnaires (one for HCWs and one for parents/caregivers). The questionnaires included information regarding individual perceptions associated with hand hygiene.ResultsWe collected 139 questionnaires from HCWs and 236 questionnaires from parents. Alcohol-based handrub was reported to be available at the point of care by 95.0% of the HCWs and in the child's room by 97.0% of the parents. For both HCWs and parents, availability of alcohol-based handrub was perceived as the most useful action for improving adherence to hand hygiene (scores ≥ 6 on a 7-point Likert-type scale: 84.8% [CI95%78.0-90.1] for HCWs and 87.9% [CI95% 83.3-91.7] for parents). Parents' reminding HCWs to perform hand hygiene was perceived as the least useful action (scores ≥ 6: 48.9% [CI95% 40.5-57.3] for HCWs and 55.7% [CI95% 49.2-62.1] for parents). Factors that affected HCWs' perceptions of the effectiveness of actions for improving adherence to hand hygiene included years of practice, type of ward and previous formal training on hand hygiene. For parents, factors affecting perceptions included previous information on hand hygiene and previous hospitalizations for their child.ConclusionsInvestigating HCWs' and parents' perceptions of measures for improving adherence can provide useful information for implementing actions for hand-hygiene promotion in children's hospitals. In this study, HCWs' and parents' perceptions were similar; alcohol-based hand-rub availability was perceived as the most useful tool, confirming its crucial role in multimodal interventions. Poor perception of inviting parents to remind HCWs to perform hand-hygiene has been previously observed, and deserves further investigation. Information and education activities were associated with more positive perceptions regarding various improvement measures. Though the relationship between perceptions and behaviours remains to be fully determined, HCWs should participate in formal training and families should be properly informed, not only to increase knowledge but also to improve perceptions on effectiveness of actions to be implemented.

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Section: Discussionmentioning

confidence: 99%

Healthcare workers' and parents' perceptions of measures for improving adherence to hand-hygiene

et al. 2011

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“…25,26 Respondents also seem to have unrealistic estimations of their own behavior. 5,27,28 Compared with the direct observation …”

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confidence: 99%

Behavioral Determinants of Hand Hygiene Compliance in Intensive Care Units

Wandel¹,

Maes²,

Labeau³

et al. 2010

American Journal of Critical Care

132

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Background Although hand hygiene is the most effective measure for preventing cross-infection, overall compliance is poor among health care workers. Objectives To identify and describe predictors and determinants of noncompliance with hand hygiene prescriptions in intensive care unit nurses by means of a questionnaire. Methods A questionnaire based on a behavioral theory model was filled out by 148 nurses working on a 40-bed intensive care unit in a university hospital. Subjects were asked to fill out the 56-item questionnaire twice within a 2-to 6-week period. During this period, no interventions to enforce hand hygiene occurred on the unit. Results Response rate for the test was 73% (108/148); response rate for the retest was 53% (57/108). The mean self-reported compliance rate was 84%. Factor analysis revealed 8 elementary factors potentially associated with compliance. Internal consistency of the scales was acceptable. Intraclass correlation was low (<0.60) for 2 subscales but acceptable (>0.60) for 6 subscales. A low self-efficacy was independently associated with noncompliance (β = .379; P = .001). After exclusion of this variable, a negative attitude toward time-related barriers was associated with noncompliance (β = -.147; P < .001). Conclusions Neither having good theoretical knowledge of hand hygiene guidelines nor social influence or moral perceptions had any predictive value relative to hand hygiene practice. A valid questionnaire to identify predictors and determinants of noncompliance with hand hygiene has been designed. Nurses reporting a poor self-efficacy or a poor attitude toward time-related barriers appear to be less compliant. (American Journal of Critical Care. 2010;19:230-240) BEHAVIORAL DETERMINANTS OF HAND HYGIENE COMPLIANCE IN INTENSIVE CARE UNITS C E 1.0 Hour Notice to CE enrollees:A closed-book, multiple-choice examination following this article tests your under standing of the following objectives:1. Recognize the impact of behavioral determinants on compliance with hand hygiene recommendations. 2. Describe determinants of noncompliance with hand hygiene prescriptions among nurses in a general intensive care unit. 3. Understand how a low self-efficacy and a negative attitude toward time-related barriers are predictors of poor compliance with hand hygiene recommendations. In accordance with the attitude-social influenceself-efficacy model, 12 which combines Fishbein and Ajzen's theory of reasoned action 13 and Bandura's social learning theory, 14 attitude, social influence, and self-efficacy are valid concepts in predicting one's intention to change one's behavior or even one's actual change in behavior. 15,16 Attitude is primordially based on earlier experiences: behavior that has led to success will be reinforced and vice versa. Although one's general attitude toward a certain behavior is often the result of success and failure (or perceived advantage and disadvantage), not all attitudes are based on reason and logical sense. Some attitudes can be very rigid and based on highly ...

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“…This study did not address the issue of changes in handwashing behaviour caused by the presence of the observer. There is some evidence that behaviours like handwashing which are habits that are practised frequently are changed very little under observation (McLane et al 1983). There are two ways to deal with this problem; observe handwashing clandestinely, or make observations over an extended period of time so that subjects will become accustomed to the presence of the observer.…”

Section: Discussionmentioning

confidence: 99%