Quantitative Measurement of Hand Hygiene Behavior in Hospice Environments Using An Automated Personal Hand Hygiene System

Hand hygiene prevents cross-infection in hospitals, but compliance with recommended instructions often is poor among healthcare workers. Although some previous interventions to improve compliance have been successful, none has achieved lasting improvement. This article reviews reported barriers to appropriate hand hygiene and factors associated with poor compliance.Easy access to hand hygiene in a timely fashion and the availability of skin-care lotion both appear to be necessary pre-requisites for appropriate hand-hygiene behavior. In particular, in high-demand situations, hand rub with an alcohol-based solution appears to be the only alternative that allows a decent compliance. The hand-hygiene compliance level does not rely on individual factors alone, and the same can be said for its promotion. Because of the complexity of the process of change, it is not surprising that solo interventions often fail, and multimodal, multidisciplinary strategies are necessary. A framework that includes parameters to be considered for hand-hygiene promotion is proposed, based on epidemiologically driven evidence and review of the current knowledge. Strategies for promotion in hospitals should include reasons for noncompliance with recommendations at individual, group, and institutional levels. Potential tools for change should address each of these elements and consider their interactivity.

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Differences in Hand Hygiene Behavior Related to the Contamination Risk of Healthcare Activities in Different Groups of Healthcare Workers

Infection Control and Hospital Epidemiology ◽

10.1086/502378 ◽

2004 ◽

Vol 25 (3) ◽

pp. 203-206 ◽

Cited By ~ 48

Author(s):

Constanze Wendt ◽

Donald Knautz ◽

Heike von Baum

Keyword(s):

Observational Study ◽

Hand Hygiene ◽

Teaching Hospital ◽

Healthcare Workers ◽

University Hospital ◽

Contamination Risk ◽

Hygiene Behavior

AbstractBackground:The Fulkerson scale lists 15 typical clinical activities ranked according to their risk of hand contamination.Objective:To investigate how often healthcare workers (HCWs) apply antiseptic handrubs after each of the specified activities ranked in the Fulkerson scale.Design:Observational study.Setting:University Hospital of Heidelberg, a 1,600-bed teaching hospital.Methods:Using a structured protocol, 41 observers recorded whether HCWs rubbed their hands in 1 of 15 given situations.Results:Handrubs were used in 1,115 (52.2%) of 2,138 observations. Comparatively high rates of handrub use were observed after contact with sterile materials (39.6%) and after contact with excretions (90% to 97%). Nurses used handrubs significantly more frequently than did physicians after contact with the inanimate environment, but physicians applied handrubs significantly more frequently after contact with body secretions.Conclusions:This study showed better compliance with hand hygiene than that reported by many previous studies, but compliance was still inadequate and varied significantly by type of HCW, type of activity, and location in the hospital.

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Design study to develop screen savers aimed at improving hand hygiene behavior

American Journal of Infection Control ◽

10.1016/j.ajic.2016.01.028 ◽

2016 ◽

Vol 44 (8) ◽

pp. 860-867 ◽

Cited By ~ 2

Author(s):

Anne Marie Weggelaar-Jansen ◽

Esther van Buren-Jansen ◽

Sabine van 't Schip ◽

Johan J.M. Pel ◽

Anna P. Nieboer ◽

...

Keyword(s):

Hand Hygiene ◽

Design Study ◽

Hygiene Behavior

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Hand(y) hygiene insights: Applying three theoretical models to investigate hospital patients’ and visitors’ hand hygiene behavior

PLoS ONE ◽

10.1371/journal.pone.0245543 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245543 ◽

Cited By ~ 1

Author(s):

Susanne Gaube ◽

Peter Fischer ◽

Eva Lermer

Keyword(s):

Hand Hygiene ◽

Social Influence ◽

Healthcare Professionals ◽

Theoretical Domains Framework ◽

Theoretical Models ◽

Equation Modeling ◽

Suitable Model ◽

Hygiene Practice ◽

Hygiene Behavior ◽

Hospital Patients

Background Improving hand hygiene in hospitals is the most efficient method to prevent healthcare-associated infections. The hand hygiene behavior of hospital patients and visitors is not well-researched, although they pose a risk for the transmission of pathogens. Therefore, the present study had three aims: (1) Finding a suitable theoretical model to explain patients’ and visitors’ hand hygiene practice; (2) Identifying important predictors for their hand hygiene behavior; and (3) Comparing the essential determinants of hand hygiene behavior between healthcare professionals from the literature to our non-professional sample. Methods In total N = 1,605 patients and visitors were surveyed on their hand hygiene practice in hospitals. The employed questionnaires were based on three theoretical models: a) the Theory of Planned Behavior (TPB); b) the Health Action Process Approach (HAPA); and c) the Theoretical Domains Framework (TDF). Structural equation modeling was used to analyze the data. To compare our results to the determinants of healthcare workers’ hand hygiene behavior, we searched for studies that used one of the three theoretical models. Results Among patients, 52% of the variance in the hand hygiene behavior was accounted for by the TDF domains, 44% by a modified HAPA model, and 40% by the TPB factors. Among visitors, these figures were 59%, 37%, and 55%, respectively. Two clusters of variables surfaced as being essential determinants of behavior: self-regulatory processes and social influence processes. The critical determinants for healthcare professionals’ hand hygiene reported in the literature were similar to the findings from our non-professional sample. Conclusions The TDF was identified as the most suitable model to explain patients’ and visitors’ hand hygiene practices. Patients and visitors should be included in existing behavior change intervention strategies. Newly planned interventions should focus on targeting self-regulatory and social influence processes to improve effectiveness.

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Exploring Determinants of Hand Hygiene among Hospital nurses: a qualitative study

10.21203/rs.3.rs-19852/v4 ◽

2020 ◽

Author(s):

Mohtasham Ghaffari ◽

Sakineh Rakhshanderou ◽

Ali Safari-Moradabadi ◽

Hassan Barkati

Keyword(s):

Content Analysis ◽

Qualitative Study ◽

Hand Hygiene ◽

Nursing Staff ◽

Behavioral Control ◽

Qualitative Content Analysis ◽

Perceived Behavioral Control ◽

Structured Interviews ◽

Factors Affecting ◽

Hygiene Behavior

Abstract Background: The present research is a qualitative one aiming to determine factors affecting hand-hygiene behavior of the nursing staff in Shariati Hospital of Tehran, Iran. Methods: This was a qualitative study performed using content analysis approach. Considering the aim of the study, 16 in-depth semi-structured interviews were held with the nursing staff of Shariati Hospital of Tehran University of Medical Sciences. A convenient sampling was performed and continued until data saturation and until no new codes and categories were obtained. Data were analyzed through a qualitative content analysis based on the Graham and landsman method. Directed qualitative content analysis was done in order to analyze the data. Results: The results of this study revealed 3 main themes in the Theory of Planned Behavior (TPB) (attitude, subjective norms and perceived behavioral control) and 8 main themes in the outside the framework (environment, perceptions, life style, morality, education, organizational culture, salience and personality). Conclusion: Due to the other factors also found in this study, an integration of theories and models for designing of interventions is recommended to increase adherence to hand hygiene behavior.

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Influence of workload, mental health and professional quality of life on healthcare workers’ hand hygiene behavior in medical aid during COVID-19 pandemic

10.21203/rs.3.rs-30058/v1 ◽

2020 ◽

Author(s):

Qian Zhou ◽

Xinping Zhang

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Hand Hygiene ◽

Structural Equation ◽

Healthcare Workers ◽

Professional Quality Of Life ◽

Final Model ◽

Professional Quality ◽

Hygiene Behavior

Abstract BackgroundAppropriate hand hygiene behavior is much crucial during COVID-19 pandemic, which is influenced by workload, mental health and professional quality of life. The increasing workload, worse mental health and negative professional quality of life are severe challenges for healthcare workers, whereas the evidence of mechanism between them and hand hygiene behavior are limited. This study aimed to understand and model how HCWs’ hand hygiene behaviors were influenced by workload, mental health and professional quality of life.MethodsA total of 1,734 healthcare workers were investigated, covering self-reported hand hygiene behavior, mental health, workload, professional quality of life and socio-demographic characteristics. Structural equation modelling was conducted to confirm interrelationships and parameters among the variables.Findings The final model had a good fit (CFI=0.980; TLI=0.941; RMSEA=0.055). Higher workload was linked to worse mental health (β = 0.165, p < 0.001) and higher burnout (β = 0.183, p < 0.001). Worse mental health was linked to higher burnout (β = 0.339, p < 0.001). The higher burnout was associated with worse self-reported hand hygiene behavior (β = -0.302, p < 0.001).ConclusionWorkload is positively associated with mental health and burnout; mental health is positively related to burnout; burnout is negatively associated with hand hygiene behavior. Thus, hand hygiene behavior can be promoted by the strategy to decrease the workload, burnout and enhance mental health.

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