Abstract
BackgroundCareful hand hygiene (HH) is the single most important factor in preventing the transmission of infections to patients, but compliance is difficult to achieve and maintain. A lack of understanding of the processes involved in changing staff behaviour may contribute to the failure to achieve success. The purpose of this study was to identify nurses’ and administrators’ perceived barriers and facilitators to current HH practices and the implementation of a new electronic monitoring technology for HH.MethodsTen key informant interviews (three administrators and seven nurses) were conducted to explore barriers and facilitators related to HH and the impact of the new technology on outcomes. The semi structured interviews were based on the Theoretical Domains Framework by Michie et al. and conducted prior to intervention implementation. Data were explored using an inductive qualitative analysis approach. Data between administrators and nurses were compared.ResultsIn 9 of the 12 domains, nurses and administrators differed in their responses. Administrators believed that nurses have insufficient knowledge and skills to perform HH, whereas the nurses were confident they had the required knowledge and skills. Nurses focused on immediate consequences, whereas administrators highlighted long-term outcomes of the system. Nurses concentrated foremost on their personal safety and their families’ safety as a source of motivation to perform HH, whereas administrators identified professional commitment, incentives, and goal setting. Administrators stated that the staff do not have the decision processes in place to judge whether HH is necessary or not. They also highlighted the positive aspects of teams as a social influence, whereas nurses were not interested in group conformity or being compared to others. Nurses described the importance of individual feedback and self-monitoring in order to increase their performance, whereas administrators reported different views.ConclusionsThis study highlights the benefits of using a structured approach based on psychological theory to inform an implementation plan for a behavior change intervention. This work is an essential step towards systematically identifying factors affecting nurses’ behaviour associated with HH.
Highlights
Careful hand hygiene (HH) is the single most important factor in preventing the transmission of infections to patients, but compliance is difficult to achieve and maintain
Research has indicated that up to 50% of hospital-acquired infections (HAIs) could be avoided with improvements in HH compliance [3,8,9]
Knowledge The knowledge domain contains the information the nurses have in regards to HH, the rationale about HH compliance, the scientific evidence supporting HH, and the procedural knowledge to perform HH and explores
Summary
Careful hand hygiene (HH) is the single most important factor in preventing the transmission of infections to patients, but compliance is difficult to achieve and maintain. It has been estimated that there are 2 million hospital-acquired infections (HAIs) per year globally, affecting 10% of hospitalized patients [2,3]. In Canada, HAIs affect 220,000 patients, resulting in 8,000 deaths per year [6]. Careful hand hygiene (HH) performed by healthcare staff is the single most important factor in preventing the transmission of pathogens [7,8,9]. In spite of this, improved compliance with HH guidelines is difficult to achieve and maintain, partially because education alone does not translate into practice change in the demanding clinical environments in which staff practice [9]. Multiple studies have documented HH compliance rates to be suboptimal, with a mean observed rate of 40% [2,12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
