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Hareesh PV, Rajkumar E, Gopi A, Sri Lakshmi K NV, Romate J. Prevalence and determinants of hand hygiene behavior among Indian population: a systematic review and meta-analysis. Sci Rep 2024; 14:2619. [PMID: 38297104 PMCID: PMC10830553 DOI: 10.1038/s41598-024-52444-2] [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: 10/22/2023] [Accepted: 01/18/2024] [Indexed: 02/02/2024] Open
Abstract
Despite a global call to action, many deaths occur yearly in developing nations from contagious diseases due to poor sanitation and hygiene. Although hand hygiene (HH) behavior was critical in preventing the COVID-19 pandemic, the sustainability of such practices is still questionable. Therefore, the current systematic review and meta-analysis investigated the prevalence and determinants of HH behavior among the Indian population (PROSPERO registration ID: CRD42022344961). Systematic searches on electronic databases, including ScienceDirect, Scopus, Web of Science, JSTOR, PubMed, and Google Scholar, targeted qualitative and quantitative studies that report HH behaviors in India. Pooled effect sizes were calculated with the inverse-variance method using random-effects models, acknowledging the study heterogeneity. Out of 1053 studies, 15 studies that met eligibility criteria were included in the qualitative synthesis. Among them, five studies were included in the meta-analyses. The overall prevalence of HH before food was 55% (95% CI = 31-78), and after the toilet was 84% (95% CI = 65-96). Subgroup analysis showed that before-food HH prevalence pre- and post-COVID-19 was 61% and 36%, respectively, whereas after-toilet HH prevalence was 91% and 74%, respectively. Meta-regression revealed statistically non-significant results for COVID-19 status. While it could not adequately explain the heterogeneity of the 'before-food prevalence' studies (Adj. R2 = - 34.80%), it did account for more than 19% in 'after-toilet prevalence' (Adj. R2 = 19.72%). This systematic review highlights various demographic, psychosocial, and environmental determinants of HH behavior. The results offer the potential for a deeper comprehension of the key factors influencing HH in India and could find implications for developing viable interventions. This aids in planning efficient promotional campaigns to enhance personal hygiene and control infectious diseases in the nation.
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Affiliation(s)
- P V Hareesh
- Department of Psychology, Central University of Karnataka, Gulbarga, Karnataka, India
| | - Eslavath Rajkumar
- Department of Liberal Arts, Indian Institute of Technology Bhilai, Durg, Chattisgarh, India.
| | - Aswathy Gopi
- Department of Psychology, Central University of Karnataka, Gulbarga, Karnataka, India
| | - N V Sri Lakshmi K
- Department of Psychology, Central University of Karnataka, Gulbarga, Karnataka, India
| | - John Romate
- Department of Psychology, Central University of Karnataka, Gulbarga, Karnataka, India
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de Barra M, Gon G, Woodd S, Graham WJ, de Bruin M, Kahabuka C, Williams AJ, Konate K, Ali SM, Said R, Penn-Kekana L. Understanding infection prevention behaviour in maternity wards: A mixed-methods analysis of hand hygiene in Zanzibar. Soc Sci Med 2021; 272:113543. [PMID: 33578309 PMCID: PMC7938378 DOI: 10.1016/j.socscimed.2020.113543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 12/16/2022]
Abstract
RATIONALE Although women in low- and middle-income countries are increasingly encouraged to give birth at facilities, healthcare-associated infection of both the mother and newborn remain common. An important cause of infection is poor hand hygiene. There is a need to understand how environmental, behavioural, and organisational factors influence hygiene practice. OBJECTIVE To understand variations between facilities and between people in hygiene behaviour and to explore potential intervention targets in four labour wards in Zanzibar. METHODS Site visits including observation of deliveries and of day-to-day workings of the facilities. Thirty-three semi-structured interviews, totalling more than 46 hours, with birth attendants, orderlies, managerial staff and mothers. Transcribed interviews and observation notes were read and coded by two authors. Themes were developed and analysed in light of existing research. RESULTS The physical preconditions for hand hygiene were met more regularly in the two highvolume facilities, where soap, water, gloves were almost always available. However, in all of the facilities, hand hygiene appeared impeded by poor ergonomics, like, for example, physical distance between water taps, gloves, or delivery beds. Recontamination of gloved hands following good hand hygiene was commonly observed, a pattern that the birth attendants attributed to high and unpredictable workload and equipment shortages. Interviews and focus groups suggested that birth attendants typically understood when and why hand hygiene should be implemented, and that they were aware of low handwashing rates among co-workers. In poorer performing facilities, managers were less inclined to visit wards and more likely to perceive hand hygiene as beyond their influence. CONCLUSIONS Observations and interviews suggest improvements in the ergonomic design of delivery rooms, including convenient availability of sinks, soap, hand gel, hand towels and gloves, may be a low-cost way to reduce the infection burden from poor hand hygiene.
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Affiliation(s)
| | - Giorgia Gon
- London School of Hygiene and Tropical Medicine, UK
| | | | - Wendy J Graham
- University of Aberdeen, UK; London School of Hygiene and Tropical Medicine, UK
| | - Marijn de Bruin
- University of Aberdeen, UK; IQ Healthcare, Radboud University Medical Centre, the Netherlands
| | | | | | | | - Said M Ali
- Public Health Laboratory Ivo de Carneri, Zanzibar
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A systematic review of factors leading to occupational injuries and fatalities. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-020-01427-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Shen L, Wang X, An J, An J, Zhou N, Sun L, Chen H, Feng L, Han J, Liu X. Implementation of WHO multimodal strategy for improvement of hand hygiene: a quasi-experimental study in a Traditional Chinese Medicine hospital in Xi'an, China. Antimicrob Resist Infect Control 2017; 6:98. [PMID: 28944053 PMCID: PMC5607599 DOI: 10.1186/s13756-017-0254-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 09/04/2017] [Indexed: 12/27/2022] Open
Abstract
Background Hand hygiene (HH) is an essential component for preventing and controlling of healthcare-associated infection (HAI), whereas compliance with HH among health care workers (HCWs) is frequently poor. This study aimed to assess compliance and correctness with HH before and after the implementation of a multimodal HH improvement strategy launched by the World Health Organization (WHO). Methods A quasi-experimental study design including questionnaire survey generalizing possible factors affecting HH behaviors of HCWs and direct observation method was used to evaluate the effectiveness of WHO multimodal HH strategy in a hospital of Traditional Chinese Medicine. Multimodal HH improvement strategy was drawn up according to the results of questionnaire survey. Compliance and correctness with HH among HCWs were compared before and after intervention. Also HH practices for different indications based on WHO “My Five Moments for Hand Hygiene” were recorded. Results In total, 553 HCWs participated in the questionnaire survey and multimodal HH improvement strategy was developed based on individual, environment and management levels. A total of 5044 observations in 23 wards were recorded in this investigation. The rate of compliance and correctness with HH improved from 66.27% and 47.75% at baseline to 80.53% and 88.35% after intervention. Doctors seemed to have better compliance with HH after intervention (84.04%) than nurses and other HCWs (81.07% and 69.42%, respectively). When stratified by indication, compliance with HH improved for all indications after intervention (P < 0.05) except for “after body fluid exposure risk” and “after touching patient surroundings”. Conclusion Implementing the WHO multimodal HH strategy can significantly improve HH compliance and correctness among HCWs. Electronic supplementary material The online version of this article (10.1186/s13756-017-0254-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Li Shen
- Department of Infection Control, Xi'an Hospital of Traditional Chinese Medicine, No.69 Feng Cheng 8th Road, Weiyang District, Xi'an, 710021 China
| | - Xiaoqing Wang
- Department of Infection Control, Xi'an Hospital of Traditional Chinese Medicine, No.69 Feng Cheng 8th Road, Weiyang District, Xi'an, 710021 China
| | - Junming An
- Department of Acupuncture and Moxibustion, Xi'an Hospital of Traditional Chinese Medicine, No.69 Feng Cheng 8th Road, Weiyang District, Xi'an, 710021 China
| | - Jialu An
- Department of Information Consultation, Library of Xi'an Jiaotong University, No.76 Yan Ta West Road, Yanta District, Xi'an, 710061 China
| | - Ning Zhou
- Department of Infection Control, Xi'an Hospital of Traditional Chinese Medicine, No.69 Feng Cheng 8th Road, Weiyang District, Xi'an, 710021 China
| | - Lu Sun
- Department of Infection Control, Xi'an Hospital of Traditional Chinese Medicine, No.69 Feng Cheng 8th Road, Weiyang District, Xi'an, 710021 China
| | - Hong Chen
- Department of Infection Control, Xi'an Hospital of Traditional Chinese Medicine, No.69 Feng Cheng 8th Road, Weiyang District, Xi'an, 710021 China
| | - Lin Feng
- Department of Cadre Health Care, Xi'an Hospital of Traditional Chinese Medicine, No.69 Feng Cheng 8th Road, Weiyang District, Xi'an, 710021 China
| | - Jing Han
- Department of Information Consultation, Library of Xi'an Jiaotong University, No.76 Yan Ta West Road, Yanta District, Xi'an, 710061 China
| | - Xiaorong Liu
- Department of Information Consultation, Library of Xi'an Jiaotong University, No.76 Yan Ta West Road, Yanta District, Xi'an, 710061 China
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Giard M, Laprugne-Garcia E, Caillat-Vallet E, Russell I, Verjat-Trannoy D, Ertzscheid MA, Vernier N, Laland C, Savey A. Compliance with standard precautions: Results of a French national audit. Am J Infect Control 2016; 44:8-13. [PMID: 26341402 DOI: 10.1016/j.ajic.2015.07.034] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 07/21/2015] [Accepted: 07/21/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Standard precautions (SPs) aim to reduce the risk of cross-transmission of microorganisms. The objectives of the present study were to assess institutional policies for SPs promotion, available resources for SPs implementation, and education of health care workers (HCWs) and their compliance with SPs. METHODS A multisite mixed-methods audit was conducted in 2011. Self-assessment questionnaires were administered at institution, ward, and HCW levels in French health care facilities (HCFs). Results were given as percentage of objectives achieved (POA) or percentage of "never or sometimes," "often," and "always" responses for each question. RESULTS A total of 1599 HCFs participated, including 14,968 wards and 203,840 HCWs. At an institutional level, the POA was 88%, covering SPs promotion (91%), procedures (99%), and SPs evaluation (63%). At the ward level, the POA was 94%, covering procedures (95%) and resources (93%). HCWs reported the best compliance for changing gloves between patients (94.5% "always"), and the worst compliance for the use of gloves for intramuscular injection and the use of eye protection in cases of blood exposure risk (34.5% and 24.4% of "always," respectively). CONCLUSIONS A literature review found no other study of SPs that included such a large study group. These results led to SPs promotion actions at local and regional levels. Reinforcement of SPs observance will be prioritized in the next national program from the French Ministry of Health.
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Self-reported hand hygiene practices, and feasibility and acceptability of alcohol-based hand rubs among village healthcare workers in Inner Mongolia, China. J Hosp Infect 2015; 90:338-43. [PMID: 25990195 PMCID: PMC4664070 DOI: 10.1016/j.jhin.2015.04.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Accepted: 04/21/2015] [Indexed: 11/24/2022]
Abstract
Background Good hand hygiene is critical to reduce the risk of healthcare-associated infections. Limited data are available on hand hygiene practices from rural healthcare systems in China. Aim To assess the feasibility and acceptability of sanitizing hands with alcohol-based hand rubs (ABHRs) among Chinese village healthcare workers, and to assess their hand hygiene practice. Methods Five hundred bottles of ABHR were given to village healthcare workers in Inner Mongolia, China. Standardized questionnaires collected information on their work load, availability, and usage of hand hygiene facilities, and knowledge, attitudes, and practices of hand hygiene. Findings In all, 369 (64.2%) participants completed the questionnaire. Although 84.5% of the ABHR recipients believed that receiving the ABHR improved their hand hygiene practice, 78.8% of recipients would pay no more than US$1.5 out of their own pocket (actual cost US$4). The majority (77.2%) who provided medical care at patients’ homes never carried hand rubs with them outside their clinics. In general, self-reported hand hygiene compliance was suboptimal, and the lowest compliance was ‘before touching a patient’. Reported top three complaints with using ABHR were skin irritation, splashing, and unpleasant residual. Village doctors with less experience practised less hand hygiene. Conclusion The overall acceptance of ABHR among the village healthcare workers is high as long as it is provided to them for free/low cost, but their overall hand hygiene practice is suboptimal. Hand hygiene education and training is needed in settings outside of traditional healthcare facilities.
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Picheansathian W, Chotibang J. Glove utilization in the prevention of cross transmission: a systematic review. ACTA ACUST UNITED AC 2015. [DOI: 10.11124/01938924-201513040-00013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Smiddy MP, O' Connell R, Creedon SA. Systematic qualitative literature review of health care workers' compliance with hand hygiene guidelines. Am J Infect Control 2015; 43:269-74. [PMID: 25728153 DOI: 10.1016/j.ajic.2014.11.007] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 11/07/2014] [Accepted: 11/13/2014] [Indexed: 10/23/2022]
Abstract
BACKGROUND Acquisition of a health care-associated infection is a substantial risk to patient safety. When health care workers comply with hand hygiene guidelines, it reduces this risk. Despite a growing body of qualitative research in this area, a review of the qualitative literature has not been published. METHODS A systematic review of the qualitative literature. RESULTS The results were themed by the factors that health care workers identified as contributing to their compliance with hand hygiene guidelines. Contributing factors were conceptualized using a theoretical background. This review of the qualitative literature enabled the researchers to take an inductive approach allowing for all factors affecting the phenomenon of interest to be explored. Two core concepts seem to influence health care workers' compliance with hand hygiene guidelines. These are motivational factors and perceptions of the work environment. Motivational factors are grounded in behaviorism, and the way in which employees perceive their work environment relates to structural empowerment. CONCLUSION Noncompliance with hand hygiene guidelines remains a collective challenge that requires researchers to adopt a consistent and standardized approach. Theoretical models should be used intentionally to better explain the complexities of hand hygiene.
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Valim MD, Marziale MHP, Richart-Martínez M, Sanjuan-Quiles Á. Instruments for evaluating compliance with infection control practices and factors that affect it: an integrative review. J Clin Nurs 2013; 23:1502-19. [PMID: 24004371 DOI: 10.1111/jocn.12316] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2013] [Indexed: 11/26/2022]
Abstract
AIMS AND OBJECTIVES To search for instruments to measure compliance with infection control practices and to report on which dimensions and contents the instruments evaluate, their psychometric characteristics, compliance and factors influencing compliance. BACKGROUND Low compliance with infection control practices has been reported among healthcare professionals around the world over the years. Existing data concerning health professionals' compliance with standard precautions are based on measuring instruments. DESIGN Integrative review. METHODS The descriptors were identified and used separately and in combination to search in the following databases: Lilacs, PubMed (MEDLINE), ISI Web of Knowledge, Scopus and CINAHL. The selected articles complied with inclusion and exclusion criteria. RESULTS Twenty-three studies were analysed, resulting in the identification of 18 instruments. No instrument addressed all compliance topics, and the most commonly addressed topics were the use of personal protective equipment, hand hygiene and safe practices in the handling of cutting material. Most authors explored content validity and some performed reliability analysis by means of Cronbach's alpha and test-retest. Countries in the sample have different human development indices, and countries with medium and low human development indices show less compliance. Some variables were strong predictors of compliance: training, perceptions of safe environment, perception of obstacles to comply with standard precautions and knowledge. CONCLUSIONS Compliance is below the recommended levels. Health professionals seem to be selective in following standard precautions. Significant influences include institutional management and psychosocial variables, which deserve further study. RELEVANCE TO CLINICAL PRACTICE Health managers and government policies and interventions should pay greater attention to this subject.
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Affiliation(s)
- Marília Duarte Valim
- Department of Fundamental Nursing, University of São Paulo at Ribeirão Preto College of Nursing, WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, São Paulo, Brazil
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Ward DJ. The barriers and motivators to learning infection control in clinical placements: interviews with midwifery students. NURSE EDUCATION TODAY 2013; 33:486-491. [PMID: 22713793 DOI: 10.1016/j.nedt.2012.05.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Revised: 05/18/2012] [Accepted: 05/25/2012] [Indexed: 06/01/2023]
Abstract
AIM To investigate the barriers to and motivators for learning infection prevention and control as identified by midwifery students. METHODS Semi-structured interviews were undertaken with 15 undergraduate midwifery students within one large university. Data were analysed using Framework Analysis. RESULTS Barriers to good clinical practice were identified by students which were concordant with previous literature related to reasons for non-compliance with infection control precautions. Issues such as competing demands specific to midwifery were also identified. Factors which act as barriers to learning good practice in placements included conflicting information and practices from different staff and placement areas and staff attitudes towards students who tried to comply with precautions. Motivators to good practice included the perceived vulnerability of infants to infection, the role modelling of good practice to new mothers and the monitoring of practice. CONCLUSIONS This study demonstrated that midwifery students perceive barriers and motivators to learning infection prevention and control in their clinical placements. Many of the barriers identified are related to the attitudes and practices of qualified staff. Some of the motivators are related specifically to midwifery practice. Midwives need to be aware of the effects of what is observed in practice on midwifery students and how their practices and attitudes can influence learning both positively and negatively. As healthcare-associated infection and poor compliance with precautions are a global problem, this research should be of benefit to midwives and midwifery educators worldwide in terms of addressing barriers and ensuring better clinical education.
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Affiliation(s)
- Deborah J Ward
- Lecturer in Infection Control, School of Nursing, Midwifery & Social Work, University of Manchester, Oxford Road, M13 9PL, United Kingdom.
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Abstract
AIM A study was undertaken involving nursing students and nurse mentors to investigate the experiences and learning needs of nursing students in relation to infection prevention. One of the objectives was to consider the views of both nursing students and mentors towards the Infection Prevention and Control Nurse (IPCN) as an important staff member in infection prevention and control. BACKGROUND Infection prevention and control is a national and international priority but compliance with precautions can be low. One reason for this is staff attitudes. Infection Prevention and Control Nurses have an important role to play in the management of patient care through clinical staff and it is therefore important that they are seen as approachable and effective in their role. METHODS Using a qualitative approach, data were obtained through semistructured interviews with 31 nursing students and 32 nurse mentors. Interviews were recorded, transcribed and analysed using framework analysis. FINDINGS Three themes emerged: attitudes towards the IPCN, effects of the presence of the IPCN and preferred qualities in IPCNs. CONCLUSIONS Areas for future research are identified and recommendations made to address areas where attitudes may affect both clinical practice and the education of nursing students in clinical placements. IMPLICATIONS FOR NURSING MANAGEMENT Nurse specialists or practitioners, who are often seen within a management role, need to consider how they work with clinical staff in order to foster more collaborative relationships.
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Affiliation(s)
- Deborah J Ward
- Lecturer in Infection Control, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
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Dixit D, Hagtvedt R, Reay T, Ballermann M, Forgie S. Attitudes and beliefs about hand hygiene among paediatric residents: a qualitative study. BMJ Open 2012; 2:bmjopen-2012-002188. [PMID: 23242484 PMCID: PMC3533101 DOI: 10.1136/bmjopen-2012-002188] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Despite the knowledge that contaminated hands play an important role in the transmission of healthcare-associated pathogens, and that hand hygiene (HH) reduces the transmission of these organisms, healthcare worker's adherence with HH is poor. OBJECTIVE To understand the common beliefs and attitudes held by paediatric residents about HH. DESIGN Qualitative study design. SETTING Tertiary care paediatric hospital in Edmonton, Canada. METHODS Semistructured interviews were conducted and themes were identified from interviews. PARTICIPANTS 22 paediatric residents. RESULTS Paediatric residents self-reported their HH adherence at 70-99% and perceived hospital-wide adherence at 45-80%. Four major themes were identified during interviews including the importance of role modelling, balancing time spent on HH with other competing factors, self-protection as a driving factor for HH and cues as an important part of habit that stimulate HH. CONCLUSIONS Staff physicians were viewed as integral to initiating group HH events, but at times, the first person in the room acted as a role model for the rest of the group. In certain instances, such as a cardiac arrest, decreased adherence with HH was viewed as acceptable. Residents engaged in HH to protect their own health. Residents relied on personal cues, which they integrated into their own HH habit. Future HH adherence strategies should ensure that the physician training environments permit the formation of good attitudes and habits towards HH. There are no additional data available.
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Affiliation(s)
- Devika Dixit
- Department of Paediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Reidar Hagtvedt
- Department of Accounting, Operations and Information Systems Alberta School of Business, University of Alberta, Edmonton, Canada
| | - Trish Reay
- Department of Strategic Management and Organization Alberta School of Business, University of Alberta, Edmonton, Canada
| | - Mark Ballermann
- Clinical Informatics North Alberta Health Services, Edmonton, Canada
| | - Sarah Forgie
- Department of Paediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
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Li L, Lin C, Wu Z, Guan J, Jia M, Yan Z. HIV-related avoidance and universal precaution in medical settings: opportunities to intervene. Health Serv Res 2011; 46:617-31. [PMID: 21029091 PMCID: PMC3032041 DOI: 10.1111/j.1475-6773.2010.01195.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To determine the association between adherence to universal precaution (UP) and avoidance attitudes toward patients living with HIV/AIDS (PLH) among service providers. DATA SOURCES/SETTING A total of 1,760 health service providers were randomly selected from 40 county hospitals in two provinces of China. STUDY DESIGN A self-administered questionnaire was used to collect demographic characteristics, UP knowledge and training, UP adherence, availability of UP supplies at work, and avoidance attitudes toward PLH in a cross-sectional survey. DATA ANALYSIS A series of regression models were used to examine associations among the UP-related factors and their relationship to avoidance attitudes toward PLH. PRINCIPAL FINDINGS UP training was associated with better knowledge of and adherence to UP and perceived availability of UP supplies in hospitals. UP training, knowledge, and adherence were significantly associated with avoidance attitudes toward PLH in medical practice. Being a nurse was also related to HIV-related avoidance. CONCLUSION UP promotion campaigns, including in-service training and reinforcement of UP adherence, could play an important role in the battle against HIV-related avoidance in medical settings. Intervention programs should focus on not only individual providers' attitudes and behaviors but also on structural support for norms shifts in the medical community.
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Affiliation(s)
- Li Li
- Center for Community Health, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, CA 90024, USA.
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Ward DJ. Infection control in clinical placements: experiences of nursing and midwifery students. J Adv Nurs 2010; 66:1533-42. [DOI: 10.1111/j.1365-2648.2010.05332.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Takahashi I, Turale S. Evaluation of individual and facility factors that promote hand washing in aged-care facilities in Japan. Nurs Health Sci 2010; 12:127-34. [DOI: 10.1111/j.1442-2018.2009.00509.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Alper SJ, Karsh BT. A systematic review of safety violations in industry. ACCIDENT; ANALYSIS AND PREVENTION 2009; 41:739-754. [PMID: 19540963 DOI: 10.1016/j.aap.2009.03.013] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2008] [Revised: 02/24/2009] [Accepted: 03/22/2009] [Indexed: 05/27/2023]
Abstract
It is widely known that intentional non-malevolent violations of safety procedures and norms occur and evidence shows that safety violations can increase the risk of accidents. However, little research about the causes of these violations in work settings exists. To help shed light on the causes, this paper systematically reviews the empirical causes of safety violations in industry. Electronic database literature searches were performed to identify relevant articles published prior to January 1, 2007. Thirteen articles met the inclusion criteria and 57 different variables were examined as predictors of safety violations. Study settings were healthcare delivery, commercial driving, aviation, mining, railroad, and construction. The predictors were categorized into individual characteristics, information/education/training, design to support worker needs, safety climate, competing goals, and problems with rules. None of the reviewed studies examined whether violations can improve system performance or safety. Methodological suggestions and a macroergonomic framework are offered for improving future studies of the epidemiology of safety violations.
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Affiliation(s)
- Samuel J Alper
- University of Wisconsin-Madison, 3217 Mechanical Engineering Building, 1513 University Avenue, Madison, WI 53706, USA.
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Hand hygiene in Iranian health care workers. Am J Infect Control 2008; 36:602-3. [PMID: 18926317 DOI: 10.1016/j.ajic.2008.01.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2007] [Revised: 12/30/2007] [Accepted: 12/28/2007] [Indexed: 11/20/2022]
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Wu S, Li L, Wu Z, Cao H, Lin C, Yan Z, Jia M, Cui H. Universal precautions in the era of HIV/AIDS: perception of health service providers in Yunnan, China. AIDS Behav 2008; 12:806-14. [PMID: 17641967 PMCID: PMC2736060 DOI: 10.1007/s10461-007-9278-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2007] [Accepted: 06/28/2007] [Indexed: 10/23/2022]
Abstract
With a rising HIV/AIDS epidemic, it has become especially important for health service providers in China to understand and correctly adhere to universal precautions. Using qualitative interview data, perspectives from both health administrators and service providers working at all levels of China's health care system were examined. Service providers admitted selective adherence and non-adherence to universal precautions in their daily medical practice, and gave their explanations for such behaviors. Lack of time to put on protective gear, gear's interference with medical procedures, lack of administrative support, heavy workload in hospitals, inaccurate risk assessment, and beliefs that compliance with universal precautions is unnecessary, time consuming and costly were mentioned as reasons behind noncompliance. Effective universal precaution interventions need to target both administrators and providers, and address both structural barriers and individual attitudinal and behavioral factors.
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Affiliation(s)
- Sheng Wu
- Jane & Terry Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California at Los Angeles, 10920 Wilshire Boulevard, Suite #350, Los Angeles, CA 90024, USA.
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Pashman J, Bradley EH, Wang H, Higa B, Fu M, Dembry LM. Promotion of hand hygiene techniques through use of a surveillance tool. J Hosp Infect 2007; 66:249-54. [PMID: 17544167 DOI: 10.1016/j.jhin.2007.03.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2007] [Accepted: 03/23/2007] [Indexed: 10/23/2022]
Abstract
Effective hand hygiene practice in a clinical healthcare setting is the most effective means to prevent, control and reduce healthcare-associated infections. Despite the introduction of hand hygiene practices and targeted campaigns, surveillance to ensure implementation of these techniques remains limited. Surveillance is widely accepted as an essential component to infection control campaigns. Therefore, we sought to design and test an easy-to-use surveillance instrument for hospital hand hygiene developed and piloted for three months in nine hospitals in China. This paper presents the resulting hand hygiene surveillance instrument as well as explicit guidelines for its implementation.
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Affiliation(s)
- J Pashman
- Department of Epidemiology and Public Health, Yale School of Medicine, USA
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Gammon J, Morgan-Samuel H, Gould D. A review of the evidence for suboptimal compliance of healthcare practitioners to standard/universal infection control precautions. J Clin Nurs 2007; 17:157-67. [PMID: 17331098 DOI: 10.1111/j.1365-2702.2006.01852.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS The review examines from international research: the extent to which practitioners comply with infection control precautions; the pertinent issues that are considered influential in compliance; what strategies have been evaluated to instigate positive behaviour changes amongst practitioners and the effect of these interventions. BACKGROUND Internationally, standard/universal precautions (UP) are regarded as fundamental in the prevention and control of infection, and effective in protecting practitioners and patients. However, adherence has been problematic and the practice of standard/UPs is globally suboptimal. DESIGN AND METHODS Literature review where relevant evidence was identified using several electronic databases, from 1994 to 2006, with number of key terms utilized. Data were extracted by using key headings, which facilitated analysis. RESULTS Thirty-seven studies were appraised. Twenty-four related to measuring practitioner compliance and 13 studies that evaluated the effect of a research intervention on compliance. In addition, other studies were included which examined the specific reasons for suboptimal compliance, or discussed infection control precautions generally. CONCLUSIONS Compliance to infection control precautions is internationally suboptimal. The evidence confirms that compliance to specific aspects of standard/UPs varies, and practitioners are selective in their application of recommended practice. Compliance does improve following a structured intervention; however, research fails to indicate for how long the intervention affects practitioner compliance, or whether compliance after a period of time returns to the norm. Several reasons for non-compliance are discussed, and recommendations for future research are suggested. Relevance to clinical practice. Suboptimal compliance has significant implications for staff safety, patient protection and the care environment. Infection control teams and researchers need to consider the reasons for non-compliance and provide a supportive environment that is conducive to the routine, long-term application of standard precautions.
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Affiliation(s)
- John Gammon
- University of Wales Swansea, Singleton Campus, Singleton Park, Swansea, UK.
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