Healthcare workers’ attitudes toward hand hygiene practices: Results of a multicentre qualitative study in Quebec

Abstract

Background: Hand hygiene (HH) is one of the most effective practices to reduce healthcare-associated infection (HAI) transmission, though compliance remains inadequate among hospital personnel. The aim of this study was to explore perceived barriers and enablers of HH compliance in hospital care and healthcare workers’ (HCW) HAI risk and severity perceptions. Methods: Qualitative study using semi-structured interviews and observations. Interview recordings were transcribed verbatim and supplemented with transcribed observations and field notes. Data was aggregated and coded thematically using a qualitative data analysis software. Results: 65 interviews and 18 observations with HCWs were conducted in nine hospital centres in Quebec, Canada. Data analysis revealed several factors that may influence HCWs’ compliance with HH recommendations. These included clinical environment factors (e.g., lack of sinks), organizational factors (e.g., inadequate staffing, demanding workloads), and communication factors (e.g., dissemination of infection prevention and control [IPAC] information, feedback, and interpersonal professional relationships). At the individual level, knowledge of IPAC and HAI risk perceptions were associated with the adoption of HH. Conclusion: Understanding the determinants of HH adoption is crucial for improving current practices and reducing HAI rates in hospital care. Our findings suggest that environmental strategies (e.g., additional sinks and HH stations) and organizational and communication strategies (e.g., continuing education and training sessions, support from hospital management, positive feedback) could help raise HCWs’ awareness of HAI prevention and adoption of HH guidelines.