Improving Healthcare Worker Hand Hygiene Compliance: The Role of Behavior Change Theories

Abstract Background Implementation science experts define champions as “supporting, marketing, and driving through an implementation, overcoming indifference or resistance that the intervention may provoke in an organization.” Many hospitals use designated clinical champions—often called “hand hygiene (HH) champions”—typically to improve hand hygiene compliance. We conducted an ethnographic examination of how infection control teams in the Veterans Health Administration (VHA) use the term “HH champion” and how they define the role. Methods An ethnographic study was conducted with infection control teams and frontline staff directly involved with hand hygiene across 10 geographically dispersed VHA facilities in the USA. Individual and group semi-structured interviews were conducted with hospital epidemiologists, infection preventionists, multi-drug-resistant organism (MDRO) program coordinators, and quality improvement specialists and frontline staff from June 2014 to September 2017. The team coded the transcripts using thematic content analysis content based on a codebook composed of inductive and deductive themes. Results A total of 173 healthcare workers participated in interviews from the 10 VHA facilities. All hand hygiene programs at each facility used the term HH champion to define a core element of their hand hygiene programs. While most described the role of HH champions as providing peer-to-peer coaching, delivering formal and informal education, and promoting hand hygiene, a majority also included hand hygiene surveillance. This conflation of implementation strategies led to contradictory responsibilities for HH champions. Participants described additional barriers to the role of HH champions, including competing priorities, staffing hierarchies, and turnover in the role. Conclusions Healthcare systems should consider narrowly defining the role of the HH champion as a dedicated individual whose mission is to overcome resistance and improve hand hygiene compliance—and differentiate it from the role of a “compliance auditor.” Returning to the traditional application of the implementation strategy may lead to overall improvements in hand hygiene and reduction of the transmission of healthcare-acquired infections.

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Effectiveness of interventions to healthcare worker hand hygiene compliance at two delivery suites of Hung Vuong hospital, Vietnam

Journal of Microbiology Immunology and Infection ◽

10.1016/j.jmii.2015.02.574 ◽

2015 ◽

Vol 48 (2) ◽

pp. S164 ◽

Cited By ~ 1

Author(s):

Tran Thi Thuy Hang ◽

Phan Thi Hang

Keyword(s):

Hand Hygiene ◽

Healthcare Worker ◽

Hand Hygiene Compliance ◽

Hygiene Compliance

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A spatiotemporal simulation study on the transmission of harmful microorganisms through connected healthcare workers in a hospital ward setting

10.21203/rs.3.rs-25278/v2 ◽

2020 ◽

Author(s):

Magnus J. M. van Niekerk ◽

Alfred A. Stein ◽

Edwina M. H. E. Doting ◽

Mariëtte M. Lokate ◽

Annemarie L. M. A. Braakman-Jansen ◽

...

Keyword(s):

Hand Hygiene ◽

Healthcare Worker ◽

Radio Frequency Identification ◽

Healthcare Workers ◽

Hand Hygiene Compliance ◽

Infection Prevention And Control ◽

Transmission Potential ◽

Occupation Group ◽

Frequency Identification ◽

Hygiene Compliance

Abstract Background: Transmission of harmful microorganisms may lead to infections and poses a major threat to patients and healthcare workers in healthcare settings. The most effective countermeasure against the transmission and spread of harmful microorganisms is the adherence to spatiotemporal hand hygiene policies, but adherence rates are relatively low and vary over space and time. The spatiotemporal effects on the transmission and spread of harmful microorganisms for varying levels of hand hygiene compliance are unknown. The objectives of this study are to (1) identify a healthcare worker occupancy group of potential super-spreaders and (2) quantify spatiotemporal effects on the transmission and spread of harmful microorganisms for varying levels of hand hygiene compliance caused by this group.Methods: Spatiotemporal data were collected in a ward of an academic hospital using radio frequency identification technology for seven days. A potential super-spreader healthcare worker occupation group was identified using the contact data derived from the frequency identification sensors. The effects of five probability distributions of hand hygiene compliance and three rates of harmful microorganism transmission were simulated using a dynamic agent-based simulation model. The effects of initial simulation assumptions on the simulation results were quantified using five risk factors.Results: Nurses, doctors and patients are together responsible for 78.8% of all contacts. Nurses made up 57% of all contacts, which is more than five times that of doctors (11.1%). This identifies nurses as the potential super-spreader healthcare worker occupation group. For initial simulation conditions of extreme lack of hand hygiene compliance (5%) and high transmission rates (5% per contact moment), a colonized nurse can transfer microbes to three of the 17 healthcare worker or patients encountered during the 87 minutes of visiting 22 rooms while colonized. The harmful microorganism transmission potential for nurses is higher during weeknights (5 pm – 7 am) and weekends as compared to weekdays (7 am – 5 pm). Conclusion: Spatiotemporal behaviour and social mixing patterns of healthcare can change the expected number of transmissions and spread of harmful microorganism by super-spreaders in a closed healthcare setting. These insights can be used to develop better-informed infection prevention and control strategies.

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Promoting the role of patients in improving hand hygiene compliance amongst health care workers

BMJ Quality Improvement Reports ◽

10.1136/bmjquality.u210787.w4336 ◽

2016 ◽

Vol 5 (1) ◽

pp. u210787.w4336 ◽

Cited By ~ 3

Author(s):

Maryam Ahmed Awaji ◽

Khaled Al-Surimi

Keyword(s):

Health Care ◽

Hand Hygiene ◽

Health Care Workers ◽

Hand Hygiene Compliance ◽

Care Workers ◽

Hygiene Compliance

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Research on Healthcare Worker Behavior To Increase Hand Hygiene Compliance in a Japanese Hospital

American Journal of Infection Control ◽

10.1016/j.ajic.2007.04.132 ◽

2007 ◽

Vol 35 (5) ◽

pp. E116

Author(s):

K. Inuzuka ◽

M. Hyodo

Keyword(s):

Hand Hygiene ◽

Healthcare Worker ◽

Hand Hygiene Compliance ◽

Worker Behavior ◽

Hygiene Compliance

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GAMBARAN KEPATUHAN TENAGA KESEHATAN DALAM MENERAPKAN HAND HYGIENE DI RAWAT INAP RSUP PROF. Dr. R D. KANDOU MANADO

e-CliniC ◽

10.35790/ecl.4.1.2016.10942 ◽

2016 ◽

Vol 4 (1) ◽

Author(s):

Citra Prasilya Karuru ◽

Theresia Isye Mogi ◽

Lidwina Sengkey

Keyword(s):

Hand Hygiene ◽

Hand Hygiene Compliance ◽

Health Workers ◽

Compliance Rate ◽

Cross Sectional ◽

Route Of Transmission ◽

Health Care Associated Infections ◽

Cross Sectional Design ◽

Hygiene Compliance

Abstract: Hands are the main route of transmission of germs during patient care. Nosocomial infection transmission can occur due to poor sanitation. Hand hygiene of health workers is very helpful in preventing the transmission of harmful germs and health care-associated infections. However, health workers still have less attention about the role of hand hygiene. This study aimed to determine the doctors and nurses’ compliance rate in implementing hand hygiene in Prof. Dr. R.D. Kandou Hospital Manado. This was an observational study with a cross-sectional design. Samples were specialist doctors, residents, and nurses in IRINA A, E, and F. The general compliance rate of hand hygiene was 5,2%. Based on the profession, the hand hygiene compliance rate of doctors was 2.4% (n=21) and of nurses 6.6% (n=113). Based on the monitored time, the compliance rate before entering rooms was 3.02% (n=39) and after entering rooms 7.35% (n=95). Conclusion: Hand hygiene compliance rate among health workers was still low.Keywords: health workers, hand hygiene compliance rate Abstrak: Tangan merupakan jalur utama penularan kuman selama perawatan pasien. Penularan infeksi nosokomial bisa terjadi akibat sanitasi yang kurang. Kebersihan tangan tenaga kesehatan sangat membantu pencegahan penularan kuman berbahaya dan mencegah infeksi terkait perawatan kesehatan. Namun, pentingnya penerapan hand hygiene masih kurang mendapat perhatian oleh tenaga kesehatan. Penelitian ini bertujuan untuk melihat gambaran kepatuhan tenaga kesehatan yakni tenaga dokter dan perawat dalam menerapkan hand hygiene di ruang rawat inap RSUP Prof. Dr. R. D. Kandou Manado. Metode penelitian yang digunakan ialah observasional dengan desain potong lintang. Sampel meliputi dokter spesialis, dokter residen, dan perawat. Angka kepatuhan keseluruhan ialah 5,2%. Berdasarkan kelompok pekerjaan, angka kepatuhan dokter 2,4% (n=21) dan perawat 6,6% (n=113). Dari dua indikasi yang diamati, angka kepatuhan sebelum masuk ruangan 3,02% (n=39) dan setelah keluar ruangan 7,35% (n=95). Simpulan: Tingkat kepatuhan hand hygiene tenaga kesehatan masih rendah.Kata kunci: tenaga kesehatan, tingkat kepatuhan hand hygiene

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Prevention of Nosocomial Infection & role of Hand Hygiene Compliance in a Private Hospital of Bangladesh

Bangladesh Critical Care Journal ◽

10.3329/bccj.v5i2.34382 ◽

2017 ◽

Vol 5 (2) ◽

pp. 83-87 ◽

Cited By ~ 1

Author(s):

Afsana Begum ◽

Md Shafiqul Bari ◽

Md Abul Kalam Azad ◽

Md Iqbal Hossain ◽

Pradip Ranjan Saha

Keyword(s):

Intensive Care Unit ◽

Critical Care ◽

Intensive Care ◽

Hand Hygiene ◽

Nosocomial Infection ◽

Hand Hygiene Compliance ◽

High Dependency Unit ◽

High Dependency ◽

Hygiene Compliance

Background: Nosocomial infection (NI) is a major cause of morbidity and mortality of patients attending the healthcare facilities all over the world. Only a few studies regarding this issue have been conducted in Bangladesh.Objective: To describe the load of NI and to assess role of hand hygiene compliance of doctors and nurses regarding its prevention.Method: In this cross-sectional study, medical records of all patients admitted from January 2014 to June 2014 were reviewed and data were collected from patients who had diagnosis of NI. Collected data includes month wise number of NI patients, types of NI, organism responsible for NI and hand hygiene compliance of doctors and nurses. Regarding hand hygiene compliance only critical care areas were considered.Results: During the study period, a total of 8769 patients were admitted in all inpatient departments and critical care areas (cardiac intensive care unit, neonatal intensive care unit, general intensive care unit, coronary care unit, general high dependency unit and cardiac high dependency unit) of the hospital and number of NI was 201 (2.29%). The highest NI was respiratory tract infection (63%) and the lowest was skin & soft tissue infection (2%). Predominant organisms responsible were E. coli (16%), acinetobacter species (15%), Pseudomonas species (14%), Klebsiella species (13%), Serratia species (13%) and Candida species (13%). The highest average hand hygiene compliance (67.67%) and lowest NI (1.14%) was observed in June 2014.Conclusion: In this study, NI rate was the lowest when the hand hygiene compliance was the highest. So, it is obvious that implementation of hand hygiene may be one of the important measures to prevent NI. So, hospitals should have strict guidelines and review measures to prevent this man made phenomenon. All these efforts will not only reduce patient morbidity, but will also reduce the use of antibiotics and healthcare costs of the country.Bangladesh Crit Care J September 2017; 5(2): 83-87

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