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Patients' Beliefs and Perceptions of Their Participation to Increase Healthcare Worker Compliance with Hand Hygiene

Published online by Cambridge University Press:  02 January 2015

Yves Longtin ,
Hugo Sax ,
Benedetta Allegranzi ,
Stéphane Hugonnet  and
Didier Pittet
Yves Longtin
Affiliation:
Faculty of Medicine, University of Geneva Hospitals, Geneva, Switzerland
Hugo Sax
Affiliation:
Faculty of Medicine, University of Geneva Hospitals, Geneva, Switzerland
Benedetta Allegranzi
Affiliation:
World Alliance for Patient Safety, World Health Organization, Geneva, Switzerland
Stéphane Hugonnet
Affiliation:
Faculty of Medicine, University of Geneva Hospitals, Geneva, Switzerland
Didier Pittet*
Affiliation:
Faculty of Medicine, University of Geneva Hospitals, Geneva, Switzerland World Alliance for Patient Safety, World Health Organization, Geneva, Switzerland
*
Infection Control Program, University of Geneva Hospitals and Faculty of Medicine, 24 Rue Micheli-du-Crest, 1211 Geneva 14, Switzerland( didier.pittet@hcuge.ch)
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Abstract

Background.

Research suggests that patients could improve healthcare workers' compliance with hand hygiene recommendations by reminding them to cleanse their hands.

Objective.

To assess patients' perceptions of a patient-participation program to improve healthcare workers' compliance with hand hygiene.

Design.

Cross-sectional survey of patient knowledge and perceptions of healthcare-associated infections, hand hygiene, and patient participation, defined as the active involvement of patients in various aspects of their health care.

Setting.

Large Swiss teaching hospital.

Results.

Of 194 patients who participated, most responded that they would not feel comfortable asking a nurse (148 respondents [76%]) or a physician (150 [77%]) to perform hand hygiene, and 57 (29%) believed that this would help prevent healthcare-associated infections. In contrast, an explicit invitation from a healthcare worker to ask about hand hygiene doubled the intention to ask a nurse (from 34% to 83% of respondents; P < .001) and to ask a physician (from 30% to 78%; P < .001). In multivariate analysis, being nonreligious, having an expansive personality, being concerned about healthcare-associated infections, and believing that patient participation would prevent healthcare-associated infections were associated with the intention to ask a nurse or a physician to perform hand hygiene (P < .05). Being of Jewish, Eastern Orthodox, or Buddhist faith was associated also with increased intention to ask a nurse (P < .05), compared with being of Christian faith.

Conclusions.

This study identifies several sociodemographic characteristics associated with the intention to ask nurses and physicians about hand hygiene and underscores the importance of a direct invitation from healthcare workers to increase patient participation and foster patient empowerment. These findings could guide the development of future hand hygiene-promotion strategies.

Information

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 30 , Issue 9 , September 2009 , pp. 830 - 839
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2009

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References

1. Patient Self-Determination Act, 42 USC §1395-1396a (1994).Google Scholar
2.World Health Organization (WHO). London Declaration: Patients for Patient Safety. Geneva, Switzerland: WHO; 2007. Available at: http:// www.who.int/patientsafety/patients_for_patient/London_Declaration_EN.pdf. Accessed July 27, 2007.Google Scholar
3.President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry. Consumer Bill of Rights and Responsibilities: Executive Summary. Washington, DC: Agency for Healthcare Research and Quality, Department of Health and Human Services; 1998. Available at: http://www.hcqualitycommission.gov/final. Accessed July 15, 2009.Google Scholar
4.Coulter, A, Ellins, J. Patient-Focused Interventions: A Review of the Evidence. London, United Kingdom: Picker Institute Europe; 2006.Google Scholar
5.Weingarten, SR, Henning, JM, Badamgarav, E, et al.Interventions used in disease management programmes for patients with chronic illness— which ones work? Meta-analysis of published reports. BMJ 2002;325:925.CrossRefGoogle ScholarPubMed
6.Guevara, JP, Wolf, FM, Grum, CM, Clark, NM. Effects of educational interventions for self management of asthma in children and adolescents: systematic review and meta-analysis. BMJ 2003;326:1308–1309.CrossRefGoogle ScholarPubMed
7.Deakin, T, McShane, CE, Cade, JE, Williams, RD. Group based training for self-management strategies in people with type 2 diabetes mellitus. Cochrane Database Syst Rev 2005(2):CD003417.Google Scholar
8.Weingart, SN, Toth, M, Eneman, J, et al.Lessons from a patient partnership intervention to prevent adverse drug events. Int J Qual Health Care 2004;16:499–507.Google Scholar
9.Moller, T, Borregaard, N, Tvede, M, Adamsen, L. Patient education—a strategy for prevention of infections caused by permanent central venous catheters in patients with haematological malignancies: a randomized clinical trial. J Hosp Infect 2005;61:330–341.CrossRefGoogle ScholarPubMed
10.McGuckin, M, Taylor, A, Martin, V, Porten, L, Salcido, R. Evaluation of a patient education model for increasing hand hygiene compliance in an inpatient rehabilitation unit. Am J Infect Control 2004;32:235–238.CrossRefGoogle Scholar
11.McGuckin, M, Waterman, R, Storr, IJ, et al.Evaluation of a patient-empowering hand hygiene programme in the UK. J Hosp Infect 2001;48:222–227.Google Scholar
12.McGuckin, M, Waterman, R, Porten, L, et al.Patient education model for increasing handwashing compliance. Am J Infect Control 1999;27:309–314.CrossRefGoogle ScholarPubMed
13.Waterman, AD, Gallagher, TH, Garbutt, J, Waterman, BM, Fraser, V, Burroughs, TE. Hospitalized patients' attitudes about and participation in error prevention. J Gen Intern Med 2006;21:367–370.Google Scholar
14.Davis, RE, Koutantji, M, Vincent, CA. How willing are patients to question healthcare staff on issues related to the quality and safety of their healthcare? An exploratory study. Qual Saf Health Care 2008;17:90–96.Google Scholar
15.Duncanson, V, Pearson, L. A study of the factors affecting the likelihood of patients participating in a campaign to improve staff hand hygiene. J Infect Prevent 2005;6:26–30.Google Scholar
16.Pittet, D, Hugonnet, S, Harbarth, S, et al.Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet 2000;356:1307–1312.CrossRefGoogle ScholarPubMed
17.Pittet, D, Simon, A, Hugonnet, S, Pessoa-Silva, CL, Sauvan, V, Perneger, TV. Hand hygiene among physicians: performance, beliefs, and perceptions. Ann Intern Med 2004;141:1–8.Google Scholar
18.Ajzen, I, Fishbein, M. Understanding Attitudes and Predicting Social Behavior. Englewood Cliffs, NJ: Prentice Hall; 1980.Google Scholar
19.O'Boyle, CA, Henly, SJ, Larson, E. Understanding adherence to hand hygiene recommendations: the theory of planned behavior. Am J Infect Control 2001;29:352–360.CrossRefGoogle ScholarPubMed
20.Rosenstock, IM, Strecher, VJ, Becker, MH. Social learning theory and the Health Belief Model. Health Educ Q 1988;15:175–183.Google Scholar
21.Jaccard, J, Weber, J, Lundmark, J. A multitrait-multimethod analysis of four attitude assessment procedures. J Exp Soc Psychology 1975;11:149–154.CrossRefGoogle Scholar
22.Katz, MH. Multivariable Analysis: A Practical Guide for Clinicians. Cambridge, United Kingdom: Cambridge University Press; 2006.Google Scholar
23.World Health Organization (WHO). WHO Guidelines on Hand Hygiene in Health Care (Advanced Draft). Geneva, Switzerland: WHO; 2006.Google Scholar
24.Hibbard, JH, Peters, E, Slovic, P, Tusler, M. Can patients be part of the solution? Views on their role in preventing medical errors. Med Care Res Rev 2005;62:601–616.Google Scholar
25.Annas, GJ. The patient's right to safety—improving the quality of care through litigation against hospitals. N Engl J Med 2006;354:2063–2066.CrossRefGoogle ScholarPubMed
26.National Patient Safety Agency (NPSA). Achieving our Aims: Evaluating the Results of the Pilot Clean Your Hands Campaign. London, United Kingdom: NPSA; 2004.Google Scholar
27.World Health Organization (WHO). World Alliance for Patient Safety, Global Patient Safety Challenge 2005-2006: Clean Care is Safer Care. Geneva, Switzerland: WHO; 2005.Google Scholar
28.McGuckin, M, Waterman, R, Shubin, A. Consumer attitudes about health care-acquired infections and hand hygiene. Am J Med Qual 2006;21:342–346.CrossRefGoogle ScholarPubMed
29.Levinson, W, Kao, A, Kuby, A, Thisted, RA. Not all patients want to participate in decision making: a national study of public preferences. J Gen Intern Med 2005;20:531–535.CrossRefGoogle ScholarPubMed
30.McKinstry, B. Do patients wish to be involved in decision making in the consultation? A cross sectional survey with video vignettes. BMJ 2000;321:867–871.Google Scholar
31.Stiggelbout, AM, Kiebert, GM. A role for the sick role: patient preferences regarding information and participation in clinical decision-making. CMAJ 1997;157:383–389.Google Scholar
32.Gaston, CM, Mitchell, G. Information giving and decision-making in patients with advanced cancer: a systematic review. Soc Sei Med 2005;61:2252–2264.Google Scholar
33.Rothenbacher, D, Lutz, MP, Porzsolt, F. Treatment decisions in palliative cancer care: patients' preferences for involvement and doctors' knowledge about it. Eur J Cancer 1997;33:1184–1189.Google Scholar
34.Hagelin, J, Hau, J, Schapiro, SJ, Suleman, MA, Carlsson, HE. Religious beliefs and opinions on clinical xenotransplantation—a survey of university students from Kenya, Sweden and Texas. Clin Transplant 2001; 15:421–425.Google Scholar
35.Suarez-Almazor, ME, Belzile, M, Bruera, E. Euthanasia and physician-assisted suicide: a comparative survey of physicians, terminally ill cancer patients, and the general population. J Clin Oncol 1997;15:418–427.CrossRefGoogle ScholarPubMed
36.Advani, AS, Atkeson, B, Brown, CL, et al.Barriers to the participation of African-American patients with cancer in clinical trials: a pilot study. Cancer 2003;97:1499–1506.CrossRefGoogle Scholar
37.Allegranzi, B, Memish, ZA, Donaldson, L, Pittet, D. Religion and culture: potential undercurrents influencing hand hygiene promotion in health care. Am J Infect Control 2009;37:28–34.Google Scholar
38.Willems, S, De Maesschalck, S, Deveugele, M, Derese, A, De Maeseneer, J. Socio-economie status of the patient and doctor-patient communication: does it make a difference? Patient Educ Couns 2005;56:139–146.Google Scholar
39.Mansell, D, Poses, RM, Kazis, L, Duefield, CA. Clinical factors that influence patients' desire for participation in decisions about illness. Arch Intern Med 2000;160:2991–2996.CrossRefGoogle ScholarPubMed
40.Witte, K, Allen, M. A meta-analysis of fear appeals: implications for effective public health campaigns. Health Educ Behav 2000;27:591–615.Google Scholar