Determinants of hand hygiene compliance among nurses in US hospitals: A formative research study

Abstract

Hand hygiene is the simplest and most effective measure for preventing healthcareassociated infections. Despite the simplicity of this procedure and advances made in infection control, hospital health care workers' compliance to hand hygiene recommendations is generally low. Nurses have the most frequent patient care interactions, and thus more opportunities to practice hand hygiene. As such, it is important to identify and understand determinants of nurses' reported compliance. Formative research was undertaken to assess the potential impact of several unexamined factors that could influence HH among nurses: professional role and status, social affiliation, social norms, and physical modifications to the work environment (as well as institutional factors like safety climate). A survey questionnaire was developed primarily to inform the creation of a behaviour change intervention. The survey looked at how these factors influence HH among nurses and sought to identify barriers and levers to reported hand hygiene. It was administered to a survey panel of acute care nurses, working in US hospitals, with a year or more of experience. Multivariate regression modelling suggested that reported hand hygiene compliance was most likely to be a function of a hospital management's communication openness, perceived performance by peers, increased interactions with patients and other staff members, and the reduction in stress, busyness, and cognitive load associated with role performance. A powerful, effective intervention on HH among nurses therefore could be directed at improving communication openness, consider the impact of perceived performance by peers, increase interactions with patients and staff, and determine how to reduce the stress and cognitive load associated with role performance.

Exploring determinants of hand hygiene among hospital nurses: a qualitative study

“…Family education, workplace rules and regulations, and a culture of hand hygiene can help promote this behavior. On the other hand, the experience of performing the behavior must become a habit, otherwise the intention to perform the action will lose its importance for the person [39][40][41]. In relation to organizational culture, Larson et al (2000) stated that efforts to improve HH performance have been insufficient because little attention has been paid to the care system, expectations, and organizational culture [42].…”

Hand hygiene knowledge, attitude, practice and hand microflora analysis of staff nurses in a rural tertiary care hospital

“…Poor hand-hygiene adherence transpires due to unavailability of hand-washing sinks, lack of time to perform hand hygiene, patient's underlying condition, outcomes of hand-hygiene products on the skin, and unawareness of the guidelines. [ 1 2 ] Healthcare syndicated infections are voluminously listed as a consequence of person-to-person transmission of nosocomial pathogens via the hands of healthcare personnel. It is also evident that the rise in levels of micro-organisms contamination has been identified due to flawed nursing practices, such as direct touching, contact with bodily fluids, and wound care.…”

Development of a behaviour change intervention using a theory-based approach, Behaviour Centred Design, to increase nurses’ hand hygiene compliance in the US hospitals

“…The greatest emphasis is placed on describing the execution and reported findings and insights from the design process (in the Build step) and the translation of the insights into intervention components (Create step). It should be noted that the results for the systematic review and the formative research are presented in other papers; however, the salient findings for each are briefly discussed below [ 18 , 19 ].…”