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The effect of eye images and a social norms message on healthcare provider hand hygiene adherence

Published online by Cambridge University Press:  10 May 2019

Sarah A. Stella Open the ORCID record for Sarah A. Stella [Opens in a new window] ,
Roger J. Stace ,
Bryan C. Knepper ,
Sara M. Reese ,
Angela Keniston ,
Marisha Burden  and
Heather L. Young
Sarah A. Stella*
Affiliation:
Department of Medicine, Denver Health Medical Center, Denver, Colorado Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
Roger J. Stace
Affiliation:
University of Colorado Denver Business School, Denver, Colorado
Bryan C. Knepper
Affiliation:
Department of Patient Safety and Quality, Denver Health Medical Center, Denver, Colorado
Sara M. Reese
Affiliation:
Department of Quality, Swedish Medical Center, Englewood, Colorado
Angela Keniston
Affiliation:
Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
Marisha Burden
Affiliation:
Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
Heather L. Young
Affiliation:
Department of Medicine, Denver Health Medical Center, Denver, Colorado Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado Department of Patient Safety and Quality, Denver Health Medical Center, Denver, Colorado
*
Author for correspondence: Sarah A. Stella, Email: Sarah.Stella@dhha.org
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Abstract

Background:

Depictions of eye images and messages encouraging compliance with social norms have successfully motivated behavioral change in a variety of experimental and applied settings. We studied the effect of these 2 visual cues on hand hygiene adherence in a cohort of hospital-based healthcare providers participating in an electronic monitoring and feedback program.

Methods:

Prospective, quasi-experimental study utilizing an interrupted time-series design. Intervention placards depicting an image of eyes, a social norms message, or a control placard were placed near soap and alcohol-based hand-rub dispensers on 2 hospital units. Placards were alternated every 10 days. Hand hygiene opportunities and adherence rates were assessed electronically via the CenTrak Hand Hygiene Compliance Solution.

Results:

A total of 166 nurses and certified nursing assistants (74 on a medical-surgical unit and 92 on a progressive care unit) were monitored electronically over the 4-month study period. In total, 184,172 electronic observations were collected (110,903 on a medical-surgical unit and 73,269 on a progressive care unit). The median daily number of electronic observations was 1,471 (interquartile range, 1,337–1,584). The preintervention baseline hand hygiene adherence rate was 70%. No statistically significant increase in hand hygiene adherence was observed as a result of either intervention.

Conclusion:

Displaying eye images or a social norms message in the hospital environment did not result in measurable improvements in HH adherence in a cohort of healthcare providers participating in an electronic monitoring and feedback program.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 40 , Issue 7 , July 2019 , pp. 748 - 754
Copyright
© 2019 by The Society for Healthcare Epidemiology of America. All rights reserved 

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