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Determinants of Good Adherence to Hand Hygiene Among Healthcare Workers Who Have Extensive Exposure to Hand Hygiene Campaigns

  • Hugo Sax (a1), Ilker Uçkay (a1), Hervé Richet (a2), Benedetta Allegranzi (a2) and Didier Pittet (a1) (a2)...
Abstract
Objective.

To quantify the different behavioral components of healthcare workers' motivation to comply with hand hygiene in a healthcare institution with a 10-year history of hand hygiene campaigning.

Design.

Cross-sectional study, by use of an anonymous, self-administered questionnaire.

Setting.

A 2,200-bed university teaching hospital.

Participants.

A stratified random sample of 2,961 medical and nursing staff.

Results.

A total of 1,042 questionnaires (35.2%) were returned. Of the respondents, 271 (26.0%) were physicians, 629 (60.4%) were nurses, and 141 (13.5%) were nursing assistants. Overall, 1,008 respondents provided information about sex; 718 (71.2%) of these were women. Respondents provided demographic information and data about various behavioral, normative, and control beliefs that determined their intentions with respect to performing hand hygiene. Among behavioral beliefs, the perception that healthcare-associated infections are severe for patients was highly ranked as a determinant of behavior by 331 (32.1%) of the respondents, and the perception that hand hygiene is effective at preventing these infections was ranked highly by 891 respondents (86.0%). Among normative beliefs, perceived social pressure from patients to perform hand hygiene was ranked highly by 760 respondents (73.7%), pressure from superiors was ranked highly by 687 (66.8%), pressure from colleagues was ranked highly by 596 (57.9%), and pressure from the person perceived to be most influential was ranked highly by 687 (68.8%). Among control beliefs, the perception that hand hygiene is relatively easy to perform was rated highly by 670 respondents (65.1%). High self-reported rates of adherence to hand hygiene (defined as performance of proper hand hygiene during 80% or more of hand hygiene opportunities) was independently associated with female sex, receipt of training in hand hygiene, participation in a previous hand hygiene campaign, peer pressure from colleagues, perceived good adherence by colleagues, and the perception that hand hygiene is relatively easy to perform.

Conclusions.

In a setting with a long tradition of hand hygiene campaigns, behavioral beliefs are strongly in favor of hand hygiene, but adherence is driven by peer pressure and the perception of high self-efficacy, rather than by reasoning about the impact of hand hygiene on patient safety. Female sex, training, and campaign exposure increased the likelihood of compliance with hand hygiene. This additional insight can help to shape future promotional activity.

Copyright
Corresponding author
Infection Control Program, University of Geneva Hospitals, 24 Rue Micheli-du-Crest, 1211 Geneva 14, Switzerland (didier.pittet@hcuge.ch)
Linked references
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4. S Stone , L Teare , B Cookson . Guiding hands of our teachers. Hand-hygiene Liaison Group. Lancet 2001;357:479480.

7. D Pittet , A Simon , S Hugonnet , CL Pessoa-Silva , V Sauvan , TV Perneger . Hand hygiene among physicians: performance, beliefs, and perceptions. Ann Intern Med 2004;141:18.

9. D Pittet , P Mourouga , TV Perneger . Compliance with handwashing in a teaching hospital. Ann Intern Med 1999;130:126130.

14. G Godin , G Kok . The theory of planned behavior: a review of its applications to health-related behaviors. Am J Health Promot 1996;11:8798.

20. D Pittet , R Stephan , S Hugonnet , C Akakpo , B Souweine , F Clergue . Hand-cleansing during postanesthesia care. Anesthesiology 2003;99:530535.

21. S Hugonnet , TV Perneger , D Pittet . Alcohol-based handrub improves compliance with hand hygiene in intensive care units. Arch Intern Med 2002;162:10371043.

22. G Gopal Rao , A Jeanes , M Osman , C Aylott , J Green . Marketing hand hygiene in hospitals—a case study. J Hosp Infect 2002;50:4247.

23. M Snow , GL White Jr, SC Alder , JB Stanford . Mentor's hand hygiene practices influence student's hand hygiene rates. Am J Infect Control 2006;34:1824.

24. M McGuckin , R Waterman , IJ Storr , et al. Evaluation of a patient-empowering hand hygiene programme in the UK. J Hosp Infect 2001;48:222227.

29. WA Smith . Social marketing: an overview of approach and effects. Inj Prev 2006;12(suppl I):i38i43.

32. EA Jenner , BC Fletcher , P Watson , FA Jones , L Miller , GM Scott . Discrepancy between self-reported and observed hand hygiene behaviour in healthcare professionals. J Hosp Infect 2006;63:418422.

33. D Pittet , L Donaldson . Clean care is safer care: a worldwide priority. Lancet 2005;366:12461247.

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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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