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Stones C, Ai W, Rutter S, Madden A. Hand Hygiene Messaging Design in the Workplace: Views From the Workforce-Introduction. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2024; 17:49-63. [PMID: 37728087 PMCID: PMC10704885 DOI: 10.1177/19375867231195646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
AIMS The study aimed to (1) discover workers' attitudes toward the use of novel video screens to improve hand sanitization in the workplace and (2) discover what workers' preferences are for hand hygiene (HH) messaging style and tone and reasons for their preferences. BACKGROUND Practicing good HH in non-medical office settings is vital to curb the spread of a range of common and infectious diseases. Despite this, workers are rarely consulting in the construction of HH messages. The qualitative views of users can provide us with the "why" rather than the "what" and can highlight areas of cynicism, concern and overall attitudes to HH. METHODS A survey was completed by 520 UK workers concerning attitudes and views toward HH messaging and the use of a video-based hand sanitizer unit. Analysis consisted of both qualitative and quantitative methods. RESULTS Workers were skeptical toward the use of digital technologies within HH interventions, and there were misgivings about the role that video could play. Results demonstrated a strong preference for positive and supportive messages. Educational and trustworthy qualities were well rated. Messages that emphasized surveillance, previously successful in a clinical setting, or guilt, were not well received. Visual approaches that utilized serious illustration were valued. CONCLUSION This study highlights how consulting workers before the design of HH initiatives is important in guiding the design process. The resultant user-centered criteria promotes the use of positive, motivational, thought-provoking, surprising, and visual approaches to HH messaging.
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Affiliation(s)
| | - Wenbo Ai
- Royal College of Art, London, United Kingdom
| | - Sophie Rutter
- Information School, Sheffield University, London, United Kingdom
| | - Andrew Madden
- Information School, Sheffield University, London, United Kingdom
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Reinoso Schiller N, Bludau A, Mathes T, König A, von Landesberger T, Scheithauer S. Unpacking nudge sensu lato: insights from a scoping review. J Hosp Infect 2024; 143:168-177. [PMID: 37949370 DOI: 10.1016/j.jhin.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/27/2023] [Accepted: 11/02/2023] [Indexed: 11/12/2023]
Abstract
Nudges may play an important role in improving infection prevention and control (IPC) in hospitals. However, despite the novelty of the framework, their objectives, strategies and implementation approaches are not new. This review aims to provide an overview of the methods typically used by nudge interventions in IPC in hospitals targeting healthcare workers (HCWs). The initial search in PubMed yielded nine hits. Consequently, the search criteria were broadened and a second search was conducted, introducing 'nudge sensu lato' which incorporates insights from sources beyond the traditional nudge framework while maintaining the same objectives, strategies and approaches. During the second search, PubMed, Epistemonikos, Web of Science and PsycInfo were searched in accordance with the PRISMA guidelines. Abstracts were screened, and reviewers from an interdisciplinary team read the full text of selected papers. In total, 5706 unique primary studies were identified. Of these, 67 were included in the review, and only four were listed as nudge sensu stricto, focusing on changing HCWs' hand hygiene. All articles reported positive intervention outcomes. Of the 56 articles focused on improving hand hygiene compliance, 71.4% had positive outcomes. For healthcare equipment disinfection, 50% of studies showed significant results. Guideline adherence interventions had a 66.7% significant outcome rate. The concept of nudge sensu lato was introduced, encompassing interventions that employ strategies, methods and implementation approaches found in the nudge framework. The findings demonstrate that this concept can enhance the scientific development of more impactful nudges. This may help clinicians, researchers and policy makers to develop and implement effective nudging interventions.
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Affiliation(s)
- N Reinoso Schiller
- Department for Infection Control and Infectious Diseases, University Medical Centre Göttingen, Georg-August University Göttingen, Göttingen, Germany.
| | - A Bludau
- Department for Infection Control and Infectious Diseases, University Medical Centre Göttingen, Georg-August University Göttingen, Göttingen, Germany
| | - T Mathes
- Department of Medical Statistics, University Medical Centre Göttingen, Georg-August University Göttingen, Göttingen, Germany
| | - A König
- Department of Gastroenterology and Gastrointestinal Oncology, University Medical Centre Göttingen, Georg-August University Göttingen, Göttingen, Germany
| | - T von Landesberger
- Chair for Visualization and Visual Analytics, University of Cologne, Cologne, Germany
| | - S Scheithauer
- Department for Infection Control and Infectious Diseases, University Medical Centre Göttingen, Georg-August University Göttingen, Göttingen, Germany
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Sartelli M, Bartoli S, Borghi F, Busani S, Carsetti A, Catena F, Cillara N, Coccolini F, Cortegiani A, Cortese F, Fabbri E, Foghetti D, Forfori F, Giarratano A, Labricciosa FM, Marini P, Mastroianni C, Pan A, Pasero D, Scatizzi M, Viaggi B, Moro ML. Implementation Strategies for Preventing Healthcare-Associated Infections across the Surgical Pathway: An Italian Multisociety Document. Antibiotics (Basel) 2023; 12:antibiotics12030521. [PMID: 36978388 PMCID: PMC10044660 DOI: 10.3390/antibiotics12030521] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 03/08/2023] Open
Abstract
Healthcare-associated infections (HAIs) result in significant patient morbidity and can prolong the duration of the hospital stay, causing high supplementary costs in addition to those already sustained due to the patient’s underlying disease. Moreover, bacteria are becoming increasingly resistant to antibiotics, making HAI prevention even more important nowadays. The public health consequences of antimicrobial resistance should be constrained by prevention and control actions, which must be a priority for all health systems of the world at all levels of care. As many HAIs are preventable, they may be considered an important indicator of the quality of patient care and represent an important patient safety issue in healthcare. To share implementation strategies for preventing HAIs in the surgical setting and in all healthcare facilities, an Italian multi-society document was published online in November 2022. This article represents an evidence-based summary of the document.
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Affiliation(s)
- Massimo Sartelli
- Department of Surgery, Macerata Hospital, 62100 Macerata, Italy
- Correspondence:
| | - Stefano Bartoli
- Vascular Surgery Unit, S. Eugenio Hospital, 00100 Roma, Italy
| | - Felice Borghi
- Oncologic Surgery Unit, Candiolo Cancer Institute FPO–IRCCS, 10060 Torino, Italy
| | - Stefano Busani
- Anaesthesia and Intensive Care Unit, University Hospital of Modena, 41124 Modena, Italy
| | - Andrea Carsetti
- Anesthesia and Intensive Care Unit, Azienda Ospedaliero Universitaria delle Marche, 60100 Ancona, Italy
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60100 Ancona, Italy
| | - Fausto Catena
- General and Emergency Surgery Unit, “Bufalini” Hospital, 47521 Cesena, Italy
| | - Nicola Cillara
- General Surgery Unit, Santissima Trinità Hospital, 09121 Cagliari, Italy
| | - Federico Coccolini
- General and Emergency Surgery Unit, Trauma Center, New Santa Chiara Hospital, University of Pisa, 56100 Pisa, Italy
| | - Andrea Cortegiani
- Department of Surgical Oncological and Oral Science, University of Palermo, 90134 Palermo, Italy
- Department of Anesthesia Intensive Care and Emergency, University Hospital “Policlinico Paolo Giaccone”, 90134 Palermo, Italy
| | - Francesco Cortese
- Emergency Surgery Unit, San Filippo Neri Hospital, 00135 Roma, Italy
| | - Elisa Fabbri
- Health and Social Services, Emilia-Romagna Region, 40127 Bologna, Italy
| | | | - Francesco Forfori
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy
| | - Antonino Giarratano
- Department of Surgical Oncological and Oral Science, University of Palermo, 90134 Palermo, Italy
- Department of Anesthesia Intensive Care and Emergency, University Hospital “Policlinico Paolo Giaccone”, 90134 Palermo, Italy
| | | | - Pierluigi Marini
- General and Emergency Surgery Unit, S. Camillo-Forlanini Hospital, 00152 Roma, Italy
| | - Claudio Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza University, 00185 Rome, Italy
| | - Angelo Pan
- Unit of Infectious Diseases, ASST Cremona, 26100 Cremona, Italy
| | - Daniela Pasero
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- Department of Emergency, Anaesthesia and Intensive Care Unit, AOU Sassari, 07100 Sassari, Italy
| | - Marco Scatizzi
- General Surgery Unit, Santa Maria Annunziata Hospital, 50012 Firenze, Italy
| | - Bruno Viaggi
- Neuro-Intensive Care Unit, Department of Anesthesiology, Careggi University Hospital, 50139 Florence, Italy
| | - Maria Luisa Moro
- Italian Multidisciplinary Society for the Prevention of Healthcare-Associated Infections, 20159 Milano, Italy
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Gázquez-López M, Martínez-García E, Martín-Salvador A, Álvarez-Serrano MA, García-García I, Caparros-Gonzalez RA, Pérez-Morente MÁ. Posters as a Tool to Improve Hand Hygiene among Health Science Students: Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11123. [PMID: 34769642 PMCID: PMC8583657 DOI: 10.3390/ijerph182111123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 10/12/2021] [Accepted: 10/20/2021] [Indexed: 01/25/2023]
Abstract
(1) Background: Numerous educational interventions have been conducted to improve hand hygiene (HH) compliance and effectiveness among nursing students, with mixed results. The aim is to evaluate the effectiveness of posters as a teaching tool and factors associated with HH quality. (2) Methods: A pre-post experimental intervention study was conducted with a total of 293 nursing students randomly assigned to two groups (experimental and control) who, before and after HH, took cell culture samples from their non-dominant hands. Only the experimental group was exposed to the poster. (3) Results: In the experimental group, significant differences were observed among students older than 22 years (p = 0.017; V = 0.188), with a higher percentage of failures (15.7% vs. 3.6%). Poster displaying was associated with passing, other variables being equal, although without statistical significance (ORa = 2.07; 95% CI = 0.81-5.26). Pre-practice hand contamination was weakly associated with lower HH quality (ORa = 0.99, 95% CI = 0.99-0.99). (4) Conclusions: The use of posters as a teaching method shows indications of efficacy. Prior hand contamination slightly affects the quality of HH. Further evaluation of teaching methods is needed to ensure good technical performance of HH to prevent the spread of infectious diseases during the COVID-19 pandemic.
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Affiliation(s)
| | - Encarnación Martínez-García
- Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (A.M.-S.); (I.G.-G.); (R.A.C.-G.)
- Guadix High Resolution Hospital, Guadix, 18500 Granada, Spain
| | - Adelina Martín-Salvador
- Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (A.M.-S.); (I.G.-G.); (R.A.C.-G.)
| | | | - Inmaculada García-García
- Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (A.M.-S.); (I.G.-G.); (R.A.C.-G.)
| | - Rafael A. Caparros-Gonzalez
- Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (A.M.-S.); (I.G.-G.); (R.A.C.-G.)
- Instituto de Investigación Biosanitaria ibs. GRANADA, 18012 Granada, Spain
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Yang Q, Wang X, Zhou Q, Tan L, Zhang X, Lai X. Healthcare workers' behaviors on infection prevention and control and their determinants during the COVID-19 pandemic: a cross-sectional study based on the theoretical domains framework in Wuhan, China. Arch Public Health 2021; 79:118. [PMID: 34193306 PMCID: PMC8242273 DOI: 10.1186/s13690-021-00641-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 06/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Infection prevention and control (IPC) measures are crucial to combat the COVID-19 pandemic. This study aimed to explore the levels and determinants of HCWs' IPC behaviors based on the theoretical domains framework (TDF), which has been shown to be effective in guiding behavior change. METHODS A cross-sectional survey was conducted in Wuhan, China in January 2020. Self-reported hand hygiene and droplet isolation behaviors (including the use of masks, gloves, goggles and gowns) were set as dependent variables. TDF domains and HCWs' characteristics were independent variables. Negative binomial regression analyses were performed to explore their relationships. RESULTS HCWs reported good IPC behaviors, while the compliance with goggle and gown use was relatively low (below 85%). Environmental context and resources domain was significantly related to hand hygiene (β = 0.018, p = 0.026), overall droplet isolation behaviors (β = 0.056, p = 0.001), goggle (β = 0.098, p = 0.001) and gown use (β = 0.101. p < 0.001). Knowledge domain was significantly related to goggle (β = 0.081, p = 0.005) and gown use (β = 0.053, p = 0.013). Emotion domain was a predictor of overall droplet isolation behaviors (β = 0.043, p = 0.016), goggle (β = 0.074, p = 0.026) and gown use (β = 0.106, p < 0.001). Social influences domain was a predictor of overall droplet isolation behaviors (β = 0.031, p = 0.029) and gown use (β = 0.039, p = 0.035). HCWs in high-risk departments had better behaviors of gown use (β = 0.158, p = 0.032). HCWs who had encountered confirmed or suspected patients reported worse behaviors of goggle (β = - 0.127, p = 0.050) and gown use (β = - 0.153, p = 0.003). CONCLUSIONS Adequate personal protective materials and human resources, education and training, as well as supervision and role model setting are necessary to improve IPC behaviors regarding the COVID-19 pandemic.
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Affiliation(s)
- Qiuxia Yang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Hangkong Road, Wuhan, 430030, Hubei Province, China
| | - Xuemei Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Hangkong Road, Wuhan, 430030, Hubei Province, China
| | - Qian Zhou
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Hangkong Road, Wuhan, 430030, Hubei Province, China
| | - Li Tan
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei Province, China
| | - Xinping Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Hangkong Road, Wuhan, 430030, Hubei Province, China.
| | - Xiaoquan Lai
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei Province, China.
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Herbert J, Horsham C, Ford H, Wall A, Hacker E. Deployment of a Smart Handwashing Station in a School Setting During the COVID-19 Pandemic: Field Study. JMIR Public Health Surveill 2020; 6:e22305. [PMID: 33006559 PMCID: PMC7575344 DOI: 10.2196/22305] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/03/2020] [Accepted: 09/22/2020] [Indexed: 12/23/2022] Open
Abstract
Background Hand hygiene is one of the most effective ways to remove germs, prevent the spread of infectious pathogens, and avoid getting sick. Since the COVID-19 pandemic began, health authorities have been advocating good hand hygiene practices. Objective The primary aim of this study is to field test a prototype smart handwashing station deployed in a school setting during the COVID-19 pandemic. Methods We deployed a smart handwashing station and examined key technological considerations including connectivity, security, and data management systems, as well as the health and safety of users. Results The smart handwashing station was deployed for 10 days in a school setting in Australia during the COVID-19 pandemic. The smart handwashing station’s electrical components remained operational during field testing and underwent robust cleaning protocols each day. The handwashing station was used 1138 times during the field test and there was no COVID-19 transmission at the school during the testing. Conclusions This study demonstrates that a personalized feedback approach using technology can successfully be implemented at a school and can provide a platform to improve hand hygiene among school-aged children.
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Affiliation(s)
| | - Caitlin Horsham
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Helen Ford
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | | | - Elke Hacker
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
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Rutter S, Stones C, Macduff C. Communicating Handwashing to Children, as Told by Children. HEALTH COMMUNICATION 2020; 35:1091-1100. [PMID: 31088232 DOI: 10.1080/10410236.2019.1613478] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Posters encouraging handwashing would seem to offer a low-cost solution addressing barriers to handwashing in schools. However, what barriers can be successfully addressed and, how effective posters targeted at children may be is not known. In this study, using a co-design methodology, seventy-nine children (aged 6 to 11) from three English schools evaluated and generated handwashing messages in two workshops.The results were then compared with an evaluation (by the authors) of handwashing posters targeted at children. Messages that children considered most effective addressed barriers relating to reminders and encouragement, and education and information (particularly germ transmission, consequence, location and avoidance).Messages that addressed time and social norms were not considered as effective.Posters targeted at children also used reminders and encouragement, and education and information messages. However, the focus of these education and information messages was on instruction (how and when to wash hands), not on germs. Unlike the posters targeted at children, the majority of children's messages were persuasive in that they did more than simply instruct. This has implications for the design of posters and educational material in handwashing interventions.
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Alsisi EA, Al-Ashaab A, Abualfaraa WA. The Development of a Smart Health Awareness Message Framework Based on the Use of Social Media: Quantitative Study. J Med Internet Res 2020; 22:e16212. [PMID: 32459627 PMCID: PMC7413284 DOI: 10.2196/16212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/27/2019] [Accepted: 02/06/2020] [Indexed: 11/17/2022] Open
Abstract
Background Social media has recently provided a remarkable means of delivering health information broadly and in a cost-effective way. Despite its benefits, some difficulties are encountered in attempting to influence the public to change their behavior in response to social media health messages. Objective This study aimed to explore the factors that affect individuals’ acceptance of using social media as a tool for receiving health awareness messages and adapting such content accordingly by developing a smart health awareness message framework. Methods A quantitative method was adapted to validate the hypotheses and proposed framework through the development of a survey based on the technology acceptance model with the extension of other constructs. The survey was distributed on the web to 701 participants from different countries via Qualtrics software; it generated 391 completed questionnaires, and the response rate was 55.8% (391/701). Results Of the 391 respondents, 121 (30.9%) used social media platforms often during the week, and 27 participants (6.9%) did not use social media. In addition, 24.0% (94/391) of the respondents used these platforms to seek health information. On the basis of the results, perceived usefulness (β=.37; P<.001), gain-framed message (β=.04; P<.001), and loss-framed message (β=.08; P<.001) were seen to positively and significantly influence people’s intention to use social media as a means to spread information about health promotion. The proposed smart health awareness message framework identifies 64.2% of the variance in intention to use, 55.4% of the variance of perceived usefulness, and 26.2% of the variance of perceived ease of use. Conclusions This study sheds light on the factors that are associated with people’s intention to use and adopt social media in the health promotion domain. The findings reveal that the intention of using social media for health awareness purposes is positively impacted by the perception of usefulness of social media and the design of health messages. Future research might seek to explore other factors that relate to people’s behavior. This point of view will assist health organizations in developing their health messages more effectively and to be patient friendly.
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Vander Weg MW, Perencevich EN, O’Shea AMJ, Jones MP, Vaughan Sarrazin MS, Franciscus CL, Goedken CC, Baracco GJ, Bradley SF, Cadena J, Forrest GN, Gupta K, Morgan DJ, Rubin MA, Thurn J, Bittner MJ, Reisinger HS. Effect of Frequency of Changing Point-of-Use Reminder Signs on Health Care Worker Hand Hygiene Adherence: A Cluster Randomized Clinical Trial. JAMA Netw Open 2019; 2:e1913823. [PMID: 31642930 PMCID: PMC6820039 DOI: 10.1001/jamanetworkopen.2019.13823] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
IMPORTANCE Although hand hygiene (HH) is considered the most effective strategy for preventing hospital-acquired infections, HH adherence rates remain poor. OBJECTIVE To examine whether the frequency of changing reminder signs affects HH adherence among health care workers. DESIGN, SETTING, AND PARTICIPANTS This cluster randomized clinical trial in 9 US Department of Veterans Affairs acute care hospitals randomly assigned 58 inpatient units to 1 of 3 schedules for changing signs designed to promote HH adherence among health care workers: (1) no change; (2) weekly; and (3) monthly. Hand hygiene rates among health care workers were documented at entry and exit to patient rooms during the baseline period from October 1, 2014, to March 31, 2015, of normal signage and throughout the intervention period of June 8, 2015, to December 28, 2015. Data analyses were conducted in April 2018. INTERVENTIONS Hospital units were randomly assigned into 3 groups: (1) no sign changes throughout the intervention period, (2) signs changed weekly, and (3) signs changed monthly. MAIN OUTCOMES AND MEASURES Hand hygiene adherence as measured by covert observation. Interrupted time series analysis was used to examine changes in HH adherence from baseline through the intervention period by group. RESULTS Among 58 inpatient units, 19 units were assigned to the no change group, 19 units were assigned to the weekly change group, and 20 units were assigned to the monthly change group. During the baseline period, 9755 HH opportunities were observed at room entry and 10 095 HH opportunities were observed at room exit. During the intervention period, a total of 15 855 HH opportunities were observed at room entry, and 16 360 HH opportunities were observed at room exit. Overall HH adherence did not change from baseline compared with the intervention period at either room entry (4770 HH events [48.9%] vs 3057 HH events [50.1%]; P = .14) or exit (6439 HH events [63.8%] vs 4087 HH events [65.2%]; P = .06). In units that changed signs weekly, HH adherence declined from baseline at room entry (-1.9% [95% CI, -2.7% to -0.8%] per week; P < .001) and exit (-0.8% [95% CI, -1.5% to 0.1%] per week; P = .02). No significant changes in HH adherence were observed in other groups. CONCLUSIONS AND RELEVANCE The frequency of changing reminder signs had no effect on HH rates overall. Units assigned to change signs most frequently demonstrated worsening adherence. Considering the abundance of signs in the acute care environment, the frequency of changing signs did not appear to provide a strong enough cue by itself to promote behavioral change. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02223455.
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Affiliation(s)
- Mark W. Vander Weg
- Center for Access and Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, Iowa
- Department of Internal Medicine, University of Iowa, Iowa City
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City
| | - Eli N. Perencevich
- Center for Access and Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, Iowa
- Department of Internal Medicine, University of Iowa, Iowa City
- Department of Epidemiology, University of Iowa, Iowa City
| | - Amy M. J. O’Shea
- Center for Access and Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, Iowa
- Department of Internal Medicine, University of Iowa, Iowa City
| | - Michael P. Jones
- Center for Access and Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, Iowa
- Department of Biostatistics, University of Iowa, Iowa City
| | - Mary S. Vaughan Sarrazin
- Center for Access and Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, Iowa
- Department of Internal Medicine, University of Iowa, Iowa City
| | - Carrie L. Franciscus
- Center for Access and Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, Iowa
| | - Cassie Cunningham Goedken
- Center for Access and Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, Iowa
| | | | | | - Jose Cadena
- South Texas Veterans Health Care System, San Antonio
- Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio
| | | | | | | | | | - Joseph Thurn
- Minneapolis VA Medical Center, Minneapolis, Minnesota
| | - Marvin J. Bittner
- Nebraska-Western Iowa Veterans Affairs Health Care System, Omaha, Nebraska
| | - Heather Schacht Reisinger
- Center for Access and Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, Iowa
- Department of Internal Medicine, University of Iowa, Iowa City
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Kelcikova S, Mazuchova L, Bielena L, Filova L. Flawed self-assessment in hand hygiene: A major contributor to infections in clinical practice? J Clin Nurs 2019; 28:2265-2275. [PMID: 30786083 DOI: 10.1111/jocn.14823] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 02/04/2019] [Accepted: 02/09/2019] [Indexed: 12/27/2022]
Abstract
AIM To assess the quality of self-assessment and the attitude of healthcare workers (HCWs) to hand hygiene (HH) as possible factors of unsatisfactory HH compliance in clinical practice. BACKGROUND Noncompliance of HH causes healthcare-acquired infections (HAI) in patients. It is assumed that HH-related infections make up approximately 80% of all infections in clinical practice. Our observations suggest that self-assessment and attitude might be surprisingly important factors. DESIGN AND METHOD The cross-sectional approach using questionnaire and direct observation was applied. We followed STROBE guidelines. In total, questionnaires of 639 HCWs of surgical departments were included in the study, and 127 HCWs had been also directly observed. RESULTS High self-assessment regarding HH compliance and its knowledge was reported by 74% and 83% of HCWs, respectively. At the same time, only 51% of HCWs positively evaluated their colleagues with respect to HH. Similar to previous studies, we have found significant differences between physicians and nurses regarding the level of self-assessment, attitude and perception of HH. Physicians were more critical in self-assessment and considered HH less important compared to nurses. The observations revealed drawbacks in HH practices. The high level of self-overassessment might be a contributing factor to noncompliance with HH. CONCLUSIONS It is necessary to establish systematic professional training and education of HCWs in relation to their HH, and to continuously monitor and evaluate the level of self-assessment in clinical practice, mainly in surgery. RELEVANCE TO CLINICAL PRACTICE A reasonable objective level of self-assessment and attitude to HH are the most important conditions for preventing of HAI in patients.
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Affiliation(s)
- Simona Kelcikova
- Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Bratislava, Slovak
| | - Lucia Mazuchova
- Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Bratislava, Slovak
| | - Lubica Bielena
- Martin University Hospital, Department of Hospital Hygiene, Martin, Slovak
| | - Lenka Filova
- Faculty of Mathematics, Physics and Informatics, Comenius University in Bratislava, Bratislava, Slovak
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Lim K, Kilpatrick C, Storr J, Seale H. Exploring the use of entertainment-education YouTube videos focused on infection prevention and control. Am J Infect Control 2018; 46:1218-1223. [PMID: 29884576 DOI: 10.1016/j.ajic.2018.05.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 05/01/2018] [Accepted: 05/02/2018] [Indexed: 10/14/2022]
Abstract
BACKGROUND As a communications strategy, education entertainment has been used to inform, influence, and shift societal and individual behaviors. Recently, there has been an increasing number of entertainment-education YouTube videos focused on hand hygiene. However, there is currently no understanding about the quality of these videos; therefore, this study aimed to explore the social media content and user engagement with these videos. METHODS The search terms "hand hygiene" and "hand hygiene education" were used to query YouTube. Video content had to be directed at a health care professional audience. Using author designed checklists, each video was systematically evaluated and grouped according to educational usefulness and was subsequently evaluated against the categories of attractiveness, comprehension, and persuasiveness. RESULTS A total of 400 videos were screened, with 70 videos retained for analysis. Of these, 55.7% (n = 39) were categorized as educationally useful. Overall, educationally useful videos scored higher than noneducationally useful videos across the categories of attractiveness, comprehension, and persuasiveness. Miscommunication of the concept of My 5 Moments for Hand Hygiene was observed in several of the YouTube videos. CONCLUSIONS The availability of educationally useful videos in relation to hand hygiene is evident; however, it is clear that there are opportunities for contributors using this medium to strengthen their alignment with social media best practice principles to maximize the effectiveness, reach, and sustainability of their content.
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Budd D, Holness DL. Raising awareness of hand-arm vibration syndrome (HAVS) using posters. Work 2018; 61:3-10. [PMID: 30223408 DOI: 10.3233/wor-182775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Hand-arm vibration syndrome (HAVS) is caused by prolonged occupational exposure to hand-transmitted vibration. Although HAVS is preventable, disease awareness and prevention knowledge are lacking in high-risk workplaces; this may contribute to under-diagnosis, delays in seeking care, and poor health outcomes. Posters may be used to increase awareness in the workplace. OBJECTIVE To conduct a pilot survey in workers with HAVS about poster use in their workplaces, their recommendations for poster campaigns and training programs, and their evaluation of HAVS awareness and prevention posters. METHODS All eligible HAVS patients in the Occupational Health Clinic at St. Michael's Hospital, in Toronto, Canada, were asked to complete a questionnaire on workplace poster use and to evaluate a set of HAVS posters. RESULTS Fifty workers participated; almost all were males, aged 50 and older, working in construction. Most indicated having non-HAVS specific awareness posters in their workplaces. There was a positive evaluation of the design, content, and potential usefulness of the posters. The poster depicting finger blanching stood out most. The poster depicting anti-vibration gloves rated highest for relatability and effectiveness at conveying disease importance. CONCLUSIONS Participants supported the proposed use of industry-specific HAVS awareness posters in their workplaces. Future research should evaluate the effectiveness of these posters in the workplace.
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Affiliation(s)
- Diandra Budd
- Division of Occupational Medicine, St. Michael's Hospital, Toronto, Ontario, Canada
| | - D Linn Holness
- Dalla Lana School of Public Health and Department of Medicine, University of Toronto,Toronto, Ontario, Canada.,Division of Occupational Medicine and Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
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13
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Caris M, Labuschagne H, Dekker M, Kramer M, van Agtmael M, Vandenbroucke-Grauls C. Nudging to improve hand hygiene. J Hosp Infect 2018; 98:352-358. [DOI: 10.1016/j.jhin.2017.09.023] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 09/24/2017] [Indexed: 12/11/2022]
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Tartari E, Pires D, Pittet D. 'One size does not fit all' - customizing hand hygiene agents, messages, and interventions. J Hosp Infect 2018. [PMID: 29530295 DOI: 10.1016/j.jhin.2018.02.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- E Tartari
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland; Department of Nursing, Faculty of Health Science, University of Malta, Msida, Malta
| | - D Pires
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland; Department of Infectious Diseases, Centro Hospitalar Lisboa Norte and Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - D Pittet
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
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15
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Clark J, Crandall PG, O’Bryan C. Climbing the Intervention Ladder to handwashing compliance: A review and directions for future research. Food Control 2018. [DOI: 10.1016/j.foodcont.2017.09.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Birnbach DJ, Rosen LF, Fitzpatrick M, Everett-Thomas R, Arheart KL. A ubiquitous but ineffective intervention: Signs do not increase hand hygiene compliance. J Infect Public Health 2016; 10:295-298. [PMID: 27422141 DOI: 10.1016/j.jiph.2016.05.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 04/21/2016] [Accepted: 05/11/2016] [Indexed: 11/28/2022] Open
Abstract
Proper hand hygiene is critical for preventing healthcare-associated infection, but provider compliance remains suboptimal. While signs are commonly used to remind physicians and nurses to perform hand hygiene, the content of these signs is rarely based on specific, validated health behavior theories. This observational study assessed the efficacy of a hand hygiene sign disseminated by the Centers for Disease Control and Prevention in an intensive care unit compared to an optimized evidence-based sign designed by a team of patient safety experts. The optimized sign was developed by four patient safety experts to include known evidence-based components and was subsequently validated by surveying ten physicians and ten nurses using a 10 point Likert scale. Eighty-two physicians and 98 nurses (102 females; 78 males) were observed for hand hygiene (HH) compliance, and the total HH compliance rate was 16%. HH compliance was not significantly different among the signs (Baseline 10% vs. CDC 18% vs. OIS 20%; p=0.280). The findings of this study suggest that even when the content and design of a hand hygiene reminder sign incorporates evidence-based constructs, healthcare providers comply only a fraction of the time.
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Affiliation(s)
- David J Birnbach
- University of Miami Miller School of Medicine, UM-JMH Center for Patient Safety (R-370A), 1611 NW 12th Avenue, Institute 4th Floor, Miami, FL 33136, USA.
| | - Lisa F Rosen
- University of Miami Miller School of Medicine, UM-JMH Center for Patient Safety, USA.
| | - Maureen Fitzpatrick
- University of Miami Miller School of Medicine, UM-JMH Center for Patient Safety, USA.
| | - Ruth Everett-Thomas
- University of Miami Miller School of Medicine, UM-JMH Center for Patient Safety, USA.
| | - Kristopher L Arheart
- University of Miami Miller School of Medicine, Clinical Research Building, Department of Public Health Science, Miami, FL 33136, USA.
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17
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Strategies to Prevent Healthcare-Associated Infections through Hand Hygiene. Infect Control Hosp Epidemiol 2016; 35 Suppl 2:S155-78. [DOI: 10.1017/s0899823x00193900] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Previously published guidelines provide comprehensive recommendations for hand hygiene in healthcare facilities. The intent of this document is to highlight practical recommendations in a concise format, update recommendations with the most current scientific evidence, and elucidate topics that warrant clarification or more robust research. Additionally, this document is designed to assist healthcare facilities in implementing hand hygiene adherence improvement programs, including efforts to optimize hand hygiene product use, monitor and report back hand hygiene adherence data, and promote behavior change. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The list of endorsing and supporting organizations is presented in the introduction to the 2014 updates.
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18
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Beyond the patient zone: Improving hand hygiene performance in a Sterilising Services Department. Infect Dis Health 2016. [DOI: 10.1016/j.idh.2016.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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19
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Honiden S, Connors GR. Barriers and Challenges to the Successful Implementation of an Intensive Care Unit Mobility Program: Understanding Systems and Human Factors in Search for Practical Solutions. Clin Chest Med 2016; 36:431-40. [PMID: 26304280 DOI: 10.1016/j.ccm.2015.05.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
ICU-acquired weakness is a common problem and carries significant morbidity. Despite evidence that early mobility can mitigate this, implementation outside of the research setting is lagging. Understanding barriers at the systems as well as individual level is a crucial step in successful implementation of an ICU mobility program. This includes taking inventory of waste, overburden and inconsistencies in the work environment. Appreciating regulative, normative as well as cultural forces at work is critical. Finally, key personnel, which include organizational leaders, innovation champions and end users of the proposed change need to be accounted for at each step during program implementation.
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Affiliation(s)
- Shyoko Honiden
- Section of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Yale University School of Medicine, 300 Cedar Street, PO Box 208057, New Haven, CT 06520-8057, USA.
| | - Geoffrey R Connors
- Section of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Yale University School of Medicine, 300 Cedar Street, PO Box 208057, New Haven, CT 06520-8057, USA
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20
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Cunningham CE, Hutchings T, Henderson J, Rimas H, Chen Y. Modeling the hospital safety partnership preferences of patients and their families: a discrete choice conjoint experiment. Patient Prefer Adherence 2016; 10:1359-72. [PMID: 27555752 PMCID: PMC4968982 DOI: 10.2147/ppa.s105605] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patients and their families play an important role in efforts to improve health service safety. OBJECTIVE The objective of this study is to understand the safety partnership preferences of patients and their families. METHOD We used a discrete choice conjoint experiment to model the safety partnership preferences of 1,084 patients or those such as parents acting on their behalf. Participants made choices between hypothetical safety partnerships composed by experimentally varying 15 four-level partnership design attributes. RESULTS Participants preferred an approach to safety based on partnerships between patients and staff rather than a model delegating responsibility for safety to hospital staff. They valued the opportunity to participate in point of service safety partnerships, such as identity and medication double checks, that might afford an immediate risk reduction. Latent class analysis yielded two segments. Actively engaged participants (73.3%) comprised outpatients with higher education, who anticipated more benefits to safety partnerships, were more confident in their ability to contribute, and were more intent on participating. They were more likely to prefer a personal engagement strategy, valued scientific evidence, preferred a more active approach to safety education, and advocated disclosure of errors. The passively engaged segment (26.7%) anticipated fewer benefits, were less confident in their ability to contribute, and were less intent on participating. They were more likely to prefer an engagement strategy based on signage. They preferred that staff explain why they thought patients should help make care safer and decide whether errors were disclosed. Inpatients, those with immigrant backgrounds, and those with less education were more likely to be in this segment. CONCLUSION Health services need to communicate information regarding risks, ask about partnership preferences, create opportunities respecting individual differences, and ensure a positive response when patients raise safety concerns.
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Affiliation(s)
- Charles E Cunningham
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, Michael G DeGroote School of Medicine, McMaster University
- Correspondence: Charles E Cunningham, Ron Joyce Children’s Health Centre, Child and Youth Mental Health Program, 237 Barton Street East, Hamilton, ON L8L 2X2, Canada, Tel +1 905 521 2100 ext 77307, Fax +1 905 577 8453, Email
| | - Tracy Hutchings
- Department of Quality and Performance, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Jennifer Henderson
- Department of Quality and Performance, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Heather Rimas
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, Michael G DeGroote School of Medicine, McMaster University
| | - Yvonne Chen
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, Michael G DeGroote School of Medicine, McMaster University
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21
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Taylor RE. The role of message strategy in improving hand hygiene compliance rates. Am J Infect Control 2015; 43:1166-70. [PMID: 26521934 DOI: 10.1016/j.ajic.2015.06.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 06/11/2015] [Accepted: 06/12/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Despite increased attention to hand hygiene over the past decade compliance rates remain relatively low. Although there have been a number of improvements in the science of hand hygiene, very little attention has been devoted to the messages that promote it. METHOD A total of 86 health care workers who are members of Association for Professionals in Infection Control and Epidemiology chapters participated in an online evaluation of 6 message strategies. The participants evaluated the strategies on ease of understanding, believability, and whether the message strategies were likely to lead to increased handwashing. RESULTS Of the 6 strategies--ego, social, sensory, routine, acute need, and ration--the social strategy was rated the most likely to lead to action. The sensory strategy was seen as not only least likely but also counterproductive. CONCLUSIONS ICPs should add a social message strategy to communication programs promoting hand hygiene. Although further testing is needed, ego, routine, and acute need strategies show promise for tapping into motivations that lead to improved compliance.
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Affiliation(s)
- Ronald E Taylor
- School of Advertising and Public Relations, University of Tennessee, Knoxville, TN.
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22
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Joshi SC, Diwan V, Tamhankar AJ, Joshi R, Shah H, Sharma M, Pathak A, Macaden R, Stålsby Lundborg C. Staff perception on biomedical or health care waste management: a qualitative study in a rural tertiary care hospital in India. PLoS One 2015; 10:e0128383. [PMID: 26023783 PMCID: PMC4449010 DOI: 10.1371/journal.pone.0128383] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 04/26/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Health care or biomedical waste, if not managed properly, can be of high risk to the hospital staff, the patients, the community, public health and the environment, especially in low and middle income settings where proper disposal norms are often not followed. Our aim was to explore perceptions of staff of an Indian rural tertiary care teaching hospital on hospital waste management. METHOD A qualitative study was conducted using 10 focus group discussions (FGDs), with different professional groups, cleaning staff, nurses, medical students, doctors and administrators. The FGD guide included the following topics: (i) role of Health Care Waste Management (HCWM) in prevention of health care associated infections, (ii) awareness of and views about HCWM-related guidelines/legislation, (iii) current HCWM practices, (iv) perception and preparedness related to improvements of the current practices, and (v) proper implementation of the available guidelines/legislation. The FGDs were recorded, transcribed verbatim, translated to English (when conducted in Hindi) and analysed using content analysis. RESULTS Two themes were identified: Theme (A), 'Challenges in integration of HCWM in organizational practice,' with the categories (I) Awareness and views about HCWM, (II) Organizational practices regarding HCWM, and (III) Challenges in Implementation of HCWM; and Theme (B), 'Interventions to improve HCWM,' with three categories, (I) Educational and motivational interventions, (II) Organizational culture change, and (III) Policy-related interventions. CONCLUSION A gap between knowledge and actual practice regarding HCWM was highlighted in the perception of the hospital staff. The participants suggested organizational changes, training and monitoring to address this. The information generated is relevant not merely to the microsystem studied but to other institutions in similar settings.
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Affiliation(s)
| | - Vishal Diwan
- Department of Public Health and Environment, R.D. Gardi Medical College, Ujjain, India
- International Center for Health Research, R.D. Gardi Medical College, Ujjain, India
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - Ashok J. Tamhankar
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Indian Initiative for Management of Antibiotic Resistance, Department of Environmental Medicine, R.D. Gardi Medical College, Ujjain, India
| | - Rita Joshi
- Department of Microbiology, R.D. Gardi Medical College, Ujjain, India
| | - Harshada Shah
- Department of Microbiology, R.D. Gardi Medical College, Ujjain, India
| | - Megha Sharma
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Department of Pharmacology, R.D. Gardi Medical College, Ujjain, India
| | - Ashish Pathak
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Department of Pediatrics, R.D. Gardi Medical College, Ujjain, India
- Department of Women and Children’s Health, International Maternal and Child Health Unit, Uppsala University, Uppsala, Sweden
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Ellingson K, Haas JP, Aiello AE, Kusek L, Maragakis LL, Olmsted RN, Perencevich E, Polgreen PM, Schweizer ML, Trexler P, VanAmringe M, Yokoe DS. Strategies to prevent healthcare-associated infections through hand hygiene. Infect Control Hosp Epidemiol 2015; 35:937-60. [PMID: 25026608 DOI: 10.1086/677145] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Previously published guidelines provide comprehensive recommendations for hand hygiene in healthcare facilities. The intent of this document is to highlight practical recommendations in a concise format, update recommendations with the most current scientific evidence, and elucidate topics that warrant clarification or more robust research. Additionally, this document is designed to assist healthcare facilities in implementing hand hygiene adherence improvement programs, including efforts to optimize hand hygiene product use, monitor and report back hand hygiene adherence data, and promote behavior change. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The list of endorsing and supporting organizations is presented in the introduction to the 2014 updates.
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24
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Sharma M, Joshi R, Shah H, Macaden R, Lundborg CS. A step-wise approach towards introduction of an alcohol based hand rub, and implementation of front line ownership- using a, rural, tertiary care hospital in central India as a model. BMC Health Serv Res 2015; 15:182. [PMID: 25924956 PMCID: PMC4424507 DOI: 10.1186/s12913-015-0840-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 04/08/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Appropriate hand hygiene is a gold standard to combat healthcare associated infections (HAIs). The World Health Organization (WHO) has recommended alcohol based hand rub (ABHR) as the most effective tool to maintain hand hygiene. In resource poor settings commercially available ABHR is not "economically accessible". The objectives of this study were to assess the acceptability of, and to build confidence for an in-house prepared (based on WHO guidelines) alcohol based hand rub among healthcare workers (HCWs) using a rural, tertiary care hospital in central India as an example. METHODS A series of activities were developed and conducted based on the Precede-Proceed model, the Trans Theoretical model of behaviour change, Front line ownership and Social marketing. A modified WHO-ABHR formulation, the 'test product' and 'WHO product evaluation form' were used for self assessment of acceptability of the 'test product'. Confidence building activities, as finger tip culture, visual portrayal method and handmade posters, were used in high-risk wards for HAIs, to build confidence for the 'test product' in removing transient flora from the hands. A locally developed feedback from was used to evaluate the impact of the activities conducted. RESULTS Overall 183 HCWs were enrolled for the assessment of the 'test product' (130- doctors and 53 nurses). Out of these 83% (108/130) doctors and 94% (50/53) nurses were satisfied with the 'test product'. The confidence building activity was conducted with 116 participants (49 doctors). After single use of the 'test product', overall a significant reduction was observed for the CFUs on the blood agar plates (0.77 Log(10), p < 0.001). A complete reduction (100%) in colony forming units on incubated blood agar plates was seen for 13% (15/116) participants. Eighty two percent (95/116) participants expressed their confidence in the 'test product'. CONCLUSION The self reported acceptance level for the 'test product' was high. The use of finger tip culture coupled with the visual portrayal was perceived as a convincing and highly effective way to develop confidence in HCWs. Thus, is the foremost step towards successful introduction of ABHR and can be seen as a model for similar settings.
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Affiliation(s)
- Megha Sharma
- Department of Pharmacology, R. D. Gardi Medical College, Ujjain, MP, India. .,Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
| | - Rita Joshi
- Department of Microbiology, R. D. Gardi Medical College, Ujjain, MP, India.
| | - Harshada Shah
- Department of Microbiology, R. D. Gardi Medical College, Ujjain, MP, India.
| | - Ragini Macaden
- Infectious Disease Unit, St. John's Medical College and Research Institute, Bangalore, India.
| | - Cecilia Stålsby Lundborg
- Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
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Ellingson K, Haas JP, Aiello AE, Kusek L, Maragakis LL, Olmsted RN, Perencevich E, Polgreen PM, Schweizer ML, Trexler P, VanAmringe M, Yokoe DS. Strategies to Prevent Healthcare-Associated Infections through Hand Hygiene. Infect Control Hosp Epidemiol 2015. [DOI: 10.1086/651677] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Previously published guidelines provide comprehensive recommendations for hand hygiene in healthcare facilities. The intent of this document is to highlight practical recommendations in a concise format, update recommendations with the most current scientific evidence, and elucidate topics that warrant clarification or more robust research. Additionally, this document is designed to assist healthcare facilities in implementing hand hygiene adherence improvement programs, including efforts to optimize hand hygiene product use, monitor and report back hand hygiene adherence data, and promote behavior change. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The list of endorsing and supporting organizations is presented in the introduction to the 2014 updates.
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Limón-Ramírez R, Gea-Velázquez de Castro MT, Aranaz-Andrés JM. [Design of a multimodal strategy including health marketing for the improvement of hand hygiene fulfillment]. Med Clin (Barc) 2014; 142:505-11. [PMID: 24387954 DOI: 10.1016/j.medcli.2013.07.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 07/22/2013] [Accepted: 07/25/2013] [Indexed: 11/20/2022]
Affiliation(s)
- Ramón Limón-Ramírez
- Servicio de Medicina Preventiva y Calidad Asistencial, Hospital de la Plana-Departament de Salut de la Plana, Vila-real, Castellón, España.
| | - María Teresa Gea-Velázquez de Castro
- Servicio de Medicina Preventiva y Calidad Asistencial, Hospital Universitari de Sant Joan d'Alacant-Departament de Salut de Sant Joan d'Alacant, Sant Joan d'Alacant, Alicante, España; Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández, Elche, Alicante, España
| | - Jesús María Aranaz-Andrés
- Servicio de Medicina Preventiva y Calidad Asistencial, Hospital Universitari de Sant Joan d'Alacant-Departament de Salut de Sant Joan d'Alacant, Sant Joan d'Alacant, Alicante, España; Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández, Elche, Alicante, España; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), España
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Anderson MEC, Sargeant JM, Weese JS. Video observation of hand hygiene practices during routine companion animal appointments and the effect of a poster intervention on hand hygiene compliance. BMC Vet Res 2014; 10:106. [PMID: 24885304 PMCID: PMC4108058 DOI: 10.1186/1746-6148-10-106] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 05/01/2014] [Indexed: 11/16/2022] Open
Abstract
Background Hand hygiene is considered one of the most important infection control measures in human healthcare settings, but there is little information available regarding hand hygiene frequency and technique used in veterinary clinics. The objectives of this study were to describe hand hygiene practices associated with routine appointments in companion animal clinics in Ontario, and the effectiveness of a poster campaign to improve hand hygiene compliance. Results Observation of hand hygiene practices was performed in 51 clinics for approximately 3 weeks each using 2 small wireless surveillance cameras: one in an exam room, and one in the most likely location for hand hygiene to be performed outside the exam room following an appointment. Data from 38 clinics were included in the final analysis, including 449 individuals, 1139 appointments before and after the poster intervention, and 10894 hand hygiene opportunities. Overall hand hygiene compliance was 14% (1473/10894), while before and after patient contact compliance was 3% (123/4377) and 26% (1145/4377), respectively. Soap and water was used for 87% (1182/1353) of observed hand hygiene attempts with a mean contact time of 4 s (median 2 s, range 1-49 s), while alcohol-based hand rub (ABHR) was used for 7% (98/1353) of attempts with a mean contact time of 8 s (median 7 s, range 1-30 s). The presence of the posters had no significant effect on compliance, although some staff reported that they felt the posters did increase their personal awareness of the need to perform hand hygiene, and the posters had some effect on product contact times. Conclusions Overall hand hygiene compliance in veterinary clinics in this study was low, and contact time with hand hygiene products was frequently below current recommendations. Use of ABHR was low despite its advantages over hand washing and availability in the majority of clinics. The poster campaign had a limited effect on its own, but could still be used as a component of a multimodal hand hygiene campaign. Improving the infection control culture in veterinary medicine would facilitate future campaigns and studies in this area, as well as overall patient and staff safety.
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Ong MS, Magrabi F, Post J, Morris S, Westbrook J, Wobcke W, Calcroft R, Coiera E. Communication interventions to improve adherence to infection control precautions: a randomised crossover trial. BMC Infect Dis 2013; 13:72. [PMID: 23388051 PMCID: PMC3599084 DOI: 10.1186/1471-2334-13-72] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Accepted: 11/08/2012] [Indexed: 11/10/2022] Open
Abstract
Background Ineffective communication of infection control requirements during transitions of care is a potential cause of non-compliance with infection control precautions by healthcare personnel. In this study, interventions to enhance communication during inpatient transfers between wards and radiology were implemented, in the attempt to improve adherence to precautions during transfers. Methods Two interventions were implemented, comprising (i) a pre-transfer checklist used by radiology porters to confirm a patient’s infectious status; (ii) a coloured cue to highlight written infectious status information in the transfer form. The effectiveness of the interventions in promoting adherence to standard precautions by radiology porters when transporting infectious patients was evaluated using a randomised crossover trial at a teaching hospital in Australia. Results 300 transfers were observed over a period of 4 months. Compliance with infection control precautions in the intervention groups was significantly improved relative to the control group (p < 0.01). Adherence rate in the control group was 38%. Applying the coloured cue resulted in a compliance rate of 73%. The pre-transfer checklist intervention achieved a comparable compliance rate of 71%. When both interventions were applied, a compliance rate of 74% was attained. Acceptability of the coloured cue was high, but adherence to the checklist was low (40%). Conclusions Simple measures to enhance communication through the provision of a checklist and the use a coloured cue brought about significant improvement in compliance with infection control precautions by transport personnel during inpatient transfers. The study underscores the importance of effective communication in ensuring compliance with infection control precautions during transitions of care.
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Affiliation(s)
- Mei-Sing Ong
- Centre for Health Informatics, University of New South Wales, Sydney, Australia.
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Al-Tawfiq JA, Pittet D. Improving hand hygiene compliance in healthcare settings using behavior change theories: reflections. TEACHING AND LEARNING IN MEDICINE 2013; 25:374-382. [PMID: 24112209 DOI: 10.1080/10401334.2013.827575] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Although hand hygiene is the most effective method for preventing healthcare-associated infections, hand hygiene practice falls short in many healthcare facilities. The compliance rate is mostly linked to system design and easily accessible hand hygiene products. System change, healthcare worker motivation, and complex behavioral considerations seem to play a significant role. SUMMARY This article discusses the application of behavioral theories in hand hygiene promotion in a theoretical manner. The program relies on the transtheoretical model (TTM) of health behavior change, John Keller's (ARCS) Model of Motivational Design, and the theory of planned behavior (TPB). Thus, the program links attitudes and behavior to hand hygiene promotion. CONCLUSIONS The TTM of health behavior change helps to tailor interventions to predict and motivate individual movement across the pathway to change. A program could be based on this theory with multiple intercalations with John Keller's ARCS and the TPB. Such a program could be strengthened by linking attitudes and behavior to promote hand hygiene. The program could utilize different strategies such as organization cultural change that may increase the attention as well as fostering the movement in the ARCS stages. In addition, modeling TPB by creating peer pressure, ability to overcome obstacles, and increasing knowledge of the role of hand hygiene may lead to the desired outcome. The understanding and application of behavior change theories may result in an effective program to improve awareness and raise intention and thus may increase the potential for success of hand hygiene promotion programs.
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Affiliation(s)
- Jaffar A Al-Tawfiq
- a Specialty Internal Medicine Unit , Saudi Aramco Medica Services Organization , Saudi Aramco , Dharan , Saudi Arabia
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Impact on hand hygiene compliance following migration to a new hospital with improved resources and the sequential introduction of World Health Organization recommendations. Am J Infect Control 2012; 40:737-41. [PMID: 22285712 DOI: 10.1016/j.ajic.2011.09.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Revised: 09/03/2011] [Accepted: 09/06/2011] [Indexed: 11/22/2022]
Abstract
BACKGROUND One commonly cited reason for inadequate hand hygiene (HH) in health care facilities is lack of handwashing sinks and alcohol hand rub (AHR). METHODS Using the World Health Organization (WHO) direct observation method, we studied HH compliance after migration from an old hospital having 1 HH station (sink and AHR) per 6 beds to a new institution with 1 per 0.85 beds. We then introduced the other WHO strategy components in a sequential manner-posters, active education, and performance feedback-and assessed the impact of the various elements over time. RESULTS Migration from the old to the new hospital was actually accompanied by a reduction in HH from 27.3% to 14.5% (P < .01), with a 52% decline in handwashing (P = .01) after patient contact. Small group interactive teaching improved HH compliance but only reached a maximum of 33.1%. No change was seen where only posters and leaflets (without educational sessions) were adopted. Significant improvement was only obtained after a performance feedback campaign coupled with increased staff accountability, reaching an overall average of 63% (P < .001). CONCLUSION Our results suggest that, on their own, better resources do not offer any guarantees of improved HH practices. However, once in place, audit and feedback-coupled with genuine administrative support and fostering of individual accountability-appear to be effective change tools to increase HH compliance.
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Filion K, KuKanich KS, Chapman B, Hardigree MK, Powell DA. Observation-based evaluation of hand hygiene practices and the effects of an intervention at a public hospital cafeteria. Am J Infect Control 2011; 39:464-70. [PMID: 21565424 DOI: 10.1016/j.ajic.2010.09.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Revised: 09/27/2010] [Accepted: 09/29/2010] [Indexed: 12/31/2022]
Abstract
BACKGROUND Hand hygiene is important before meals, especially in a hospital cafeteria where patrons may have had recent contact with infectious agents. Few interventions to improve hand hygiene have had measureable success. This study was designed to use a poster intervention to encourage hand hygiene among health care workers (HCWs) and hospital visitors (HVs) upon entry to a hospital cafeteria. METHODS Over a 5-week period, a poster intervention with an accessible hand sanitizer unit was deployed to improve hand hygiene in a hospital cafeteria. The dependent variable observed was hand hygiene attempts. Study phases included a baseline, intervention, and follow-up phase, with each consisting of 3 randomized days of observation for 3 hours during lunch. RESULTS During the 27 hours of observation, 5,551 participants were observed, and overall hand hygiene frequency was 4.79%. Hygiene attempts occurred more frequently by HCWs than HVs (P = .0008) and females than males (P = .0281). Hygiene attempts occurred more frequently after poster introduction than baseline (P = .0050), and this improvement was because of an increase in frequency of HV hand hygiene rather than HCW hand hygiene. CONCLUSION The poster intervention tool with easily accessible hand sanitizer can improve overall hand hygiene performance in a US hospital cafeteria.
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Doron SI, Kifuji K, Hynes BT, Dunlop D, Lemon T, Hansjosten K, Cheng T, Curley B, Snydman DR, Fairchild DG. A Multifaceted Approach to Education, Observation, and Feedback in a Successful Hand Hygiene Campaign. Jt Comm J Qual Patient Saf 2011; 37:3-10. [DOI: 10.1016/s1553-7250(11)37001-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Packham C. Is a more comprehensive approach to prevention of infection needed? J Hosp Infect 2010; 75:146-7. [DOI: 10.1016/j.jhin.2010.02.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Accepted: 02/12/2010] [Indexed: 11/30/2022]
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Abstract
It is generally accepted that hand hygiene is the single most effective measure to prevent health care associated infection. Similarly, education is thought to be the cornerstone of effective practice. While common sense supports the notion that hand hygiene compliance would be enhanced by producing a well informed health care worker, traditional didactic methods of teaching are often poor at invoking and sustaining behaviour change. Storytelling is gaining popularity as an educational activity as it is said to stimulate thought, reflection and enhance the learning experience. This paper, describes one way in which storytelling may be used within a hand hygiene improvement strategy.
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Affiliation(s)
- Mark Cole
- University of Nottingham, Grantham and District Hospital, 101 Manthorpe Road, Grantham, Lincolnshire NG31 8FH,
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Cole M. Exploring the hand hygiene competence of student nurses: a case of flawed self assessment. NURSE EDUCATION TODAY 2009; 29:380-388. [PMID: 19062139 DOI: 10.1016/j.nedt.2008.10.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2007] [Revised: 09/25/2008] [Accepted: 10/18/2008] [Indexed: 05/27/2023]
Abstract
Hand hygiene remains the single most effective measure to prevent hospital acquired infection and yet poor compliance is reported repeatedly. Nurses represent the largest labour group and perform the greatest amount of direct patient care in the contemporary National Health Service. They receive their initial hand hygiene training in the pre-registration curriculum within a competence framework based on knowledge, skills and attitudes. The pre-eminent training method is one that delivers behavioural competence, making the tacit assumption that compliance will follow. In this study a mixed methods approach demonstrated that students overestimated their knowledge and skills, found it difficult to give an objective account of their performance, and reported an improbable level of compliance. The reasons why people can be self serving in their judgements may be due to information processing errors, exacerbated by the model of education and training. Flawed self assessments may present major barriers to improved performance if students view their compliance as better than it actually is. Conceptualising hand hygiene as a taxonomy of learning and introducing the cognitive strategies of reflection and self assessment would better enable students to problem solve, seek out new information, draw on past experience and gain greater and deeper understanding of the complex topic of hand hygiene behaviour.
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Affiliation(s)
- Mark Cole
- School of Nursing, University of Nottingham, Grantham and District Hospital, Grantham, Lincolnshire NG31 8DG, United Kingdom.
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Tenías JM, Mayordomo C, Benavent ML, Micó MSF, García Esparza MA, Oriola RA. [Impact of an educational intervention for promoting handwashing and the rational use of gloves in a hospital]. ACTA ACUST UNITED AC 2009; 24:36-41. [PMID: 19369141 DOI: 10.1016/s1134-282x(09)70074-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2008] [Accepted: 10/06/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To estimate the impact of educational intervention on hand washing and gloves use. MATERIAL AND METHODS The educational intervention consisted of a one-hour weekly workshop aimed at doctors and nurses, with a previous questionnaire on hand-washing, a presentation talk on three key points (hand washing, use of gloves, alcohol-based solutions). Adherence to hand washing and use of gloves was re-evaluated 6-9 months after the intervention. RESULTS We conducted 34 workshops for 296 health care workers, 239 (80.4%) women and 57 (19.6%) men, with an average age of 40.1 years (range, 18-62 years). Most were nurses (41.2%), nursing assistants (37.8%) and physicians (8.2%). Compliance to hand washing ranged between 29% and 87%. The gloves were used in maneuvers not indicated (19% before giving meals and a 27.7% when performing an ECG). Compliance with hand washing 6-9 months after the workshop improved significantly (p < 0.05) in three of the 5 items. The use of gloves was not significantly different. The intensity of the intervention was inversely related to the incidence of nosocomial infections (RR for every 100 workers intervened in the previous month = 0.89; 95% CI, 0.789-1.003; p = 0.057). CONCLUSIONS The training workshops had a positive impact on hand washing compliance, but there was no significant change in the use of gloves. The introduction of education has an inverse relationship to the incidence of nosocomial infections.
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Affiliation(s)
- José María Tenías
- Servicio de Medicina Preventiva, Hospital Lluís Alcanyís, Xàtiva, Valencia, Spain.
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Gould DJ, Hewitt-Taylor J, Drey NS, Gammon J, Chudleigh J, Weinberg JR. The CleanYourHandsCampaign: critiquing policy and evidence base. J Hosp Infect 2007; 65:95-101. [PMID: 17174447 DOI: 10.1016/j.jhin.2006.09.028] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2006] [Accepted: 09/27/2006] [Indexed: 10/23/2022]
Abstract
Handwashing is considered to be the most effective way of reducing cross-infection. Rates of healthcare-associated infection and the incidence of meticillin-resistant Staphylococcus aureus are higher in the UK than in many other European countries. The government has responded by introducing the 'CleanYourHandsCampaign' throughout England and Wales, based on the success of the approach employed in Geneva. Alcohol hand rub is placed at every bedside in acute hospitals, ward housekeepers should replenish supplies and feedback on compliance is provided to health workers. Posters and other promotional materials are used to remind health workers and visitors to use the hand rub. Patients are encouraged to ask health workers if they have cleaned their hands before contact. In this paper we argue that the evidence base underpinning the CleanYourHandsCampaign is incomplete. Alcohol hand rub is acknowledged as a useful adjunct to hand hygiene but it is not effective in all circumstances. There is some evidence to support the use of feedback on performance to encourage compliance but no evidence that promotional materials such as posters or patient reminders are effective. The ethics of encouraging hospital patients to take responsibility for their own safety is questioned. Much of the success in Geneva must be attributed to the attention given to contextual factors within the organization that encouraged hand rub use, especially hospital-wide 'ownership' of the initiative by managers and senior health professionals. A customized intervention from another country that fails to consider local organizational factors likely to influence the implementation of the campaign is unlikely to be effective. It is concluded that although hand hygiene is of undoubted importance, undue emphasis should not be placed on it as a 'quick fix' to solve the unacceptably high rates of healthcare-associated infection in National Health Service hospitals.
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Affiliation(s)
- D J Gould
- St Bartholomew School of Nursing and Midwifery, City University, London, UK.
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Mah MW, Deshpande S, Rothschild ML. Social marketing: a behavior change technology for infection control. Am J Infect Control 2006; 34:452-7. [PMID: 16945693 DOI: 10.1016/j.ajic.2005.12.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2005] [Revised: 12/07/2005] [Accepted: 12/07/2005] [Indexed: 11/22/2022]
Abstract
Changing health care worker behaviors is a core function of infection control programs. The social change technologies of education and institutional policy are limited in their capacity to achieve desired behaviors on a sustained basis because they do not address the importance of opportunity and ability in practice enhancement. Social marketing addresses the health care worker's lack of opportunity and ability by offering a bundle of benefits at low cost with high accessibility and by doing this better than the behavioral status quo. This article introduces some social marketing concepts and explicates them in the context of hand hygiene promotion.
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Affiliation(s)
- Manuel W Mah
- Faculty of Medicine, The University of Calgary, Calgary, Alberta, Canada.
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Jenner EA, Jones F, Fletcher BC, Miller L, Scott GM. Hand hygiene posters: motivators or mixed messages? J Hosp Infect 2005; 60:218-25. [PMID: 15949613 DOI: 10.1016/j.jhin.2004.12.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2004] [Accepted: 12/15/2004] [Indexed: 10/25/2022]
Abstract
Poster campaigns regarding hand hygiene are commonly used by infection control teams to improve practice, yet little is known of the extent to which they are based on established theory or research. This study reports on the content analysis of hand hygiene posters (N=69) and their messages (N=75) using message-framing theory. The results showed that posters seldom drew on knowledge about effective ways to frame messages. Frequently, they simply conveyed information 'telling' rather than 'selling' and some of this was confusing. Most posters were not designed to motivate, and some conveyed mixed messages. Few used fear appeals. Hand hygiene posters could have a greater impact if principles of message framing were utilized in their design. Suggestions for gain-framed messages are offered, but these need to be tested empirically.
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Affiliation(s)
- E A Jenner
- School of Nursing and Midwifery, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB, UK.
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