Hand hygiene determinants of informal caregivers in hospitals under Pender's perspective

Abstract

Objectives: to analyze hand hygiene determinants of informal caregivers in a hospital environment. Methods: qualitative study conducted with 55 caregivers at a university hospital in the Northeast of Brazil. A semi-structured instrument was used, adapted from Nola Pender's Health Promotion Model, from which the deductive categories were derived. Results: the general behavior included hand hygiene before meals and after using the bathroom. Sensitivity to the requirements for hand hygiene was observed, but the barriers and self-efficacy consisted of the availability of soap or alcohol-based hand sanitizers, the lack of knowledge on the importance of and forgetfulness of the practice. The reinforcement on the importance of the practice and being in a contaminated environment were influencers, and commitment, warnings, and training were indispensable. Conclusions: benefits related to protection from infections were seen as positive determinants for hand hygiene adherence. For non-adherence, factors such as lack of sanitizing supplies, ignorance towards the importance of the activity, and forgetfulness stood out.

Exploring factors influencing the compliance of patients and family carers with infection prevention and control recommendations across Bangladesh, Indonesia, and South Korea

“…This is consistent with our study findings, which showed a lack of basic infrastructure for HH, i.e., water, basin, and soap, from Bangladesh and Indonesia sites. Previous studies ( 41 , 47 , 48 ) on HH compliance have consistently suggested there is a need for enhanced provision of HH facilities and materials.…”

Measuring the Self-Efficacy of Health Professionals for Practicing Hand Hygiene and Using Gloves: Development and Validation of an Instrument

“…Hand hygiene and the use of gloves are fundamental measures to prevent and control microbial transmission [1][2][3][4]. However, the use of gloves is often pointed out as a barrier that hinders the proper practice of hand hygiene [1,[4][5][6]. Some researchers suspect that this behavior is motivated by the desire for personal safety [5][6][7][8].…”

“…Despite advances in infection control and the increase in hospital epidemiology, health professionals' adherence to recommended hand hygiene practices remains unacceptably low. It is worth mentioning that in 1840, Ignaz Philip Semmelweis demonstrated the importance of hand hygiene in the microbial transmission control [1,12].…”

“…Despite the existence of guidelines for hand hygiene, cognitive, social, motivational, behavioral and awareness aspects play an important role in adherence to this very important practice for the health area [12,[15][16][17][18]. Some justifications for the low adherence of health professionals to hand hygiene recommendations include being a doctor or nursing assistant; male gender; working in an intensive care unit (ICU); working during the week versus the weekend; use of gloves and apron; carry out activities with a higher risk of cross microbial transmission; and high workload [1,19]. Furthermore, Pittet [12] adds that adherence to hand hygiene varies between different sectors of the hospital, between professional categories, according to working conditions, time of day or week, type and intensity of patient care, and definitions employed in different studies.…”

“…There are also complaints of dermatological problems such as irritation, dryness or other lesions on the health professional's skin; forgetfulness; lack of knowledge of guidelines; lack of awareness of the risk of acquiring infection; insufficient time for hand hygiene; work load; lack of staff; use of gloves; failure in training as a belief that the use of gloves does not require hand hygiene; lack of institutional stimulus; lack of active institutional participation; lack of adequate examples in the work team or leadership; neglect and little motivation [1,12,14,17,[19][20][21][22][23][24].…”