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Hand Hygiene Behavior: Translating Behavioral Research into Infection Control Practice

Part of: BARRY FARR AWARD RECIPIENTS

Published online by Cambridge University Press:  02 January 2015

Thanee Eiamsitrakoon ,
Anucha Apisarnthanarak ,
Winitra Nuallaong ,
Thana Khawcharoenporn  and
Linda M. Mundy
Thanee Eiamsitrakoon
Affiliation:
Thammasat University Hospital, Pathumthani, Thailand
Anucha Apisarnthanarak*
Affiliation:
Division of Infectious Diseases, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Winitra Nuallaong
Affiliation:
Department of Psychiatry, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Thana Khawcharoenporn
Affiliation:
Division of Infectious Diseases, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Linda M. Mundy
Affiliation:
LM Mundy, Bryn Mawr, Pennsylvania
*
Division of Infectious Diseases, Faculty of Medicine, Thammasat University, Pathumthani, Thailand10120 ([email protected])
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Abstract

Background.

In 2009, the World Health Organization (WHO) recommended “My Five Moments for Hand Hygiene” (5MHH) to optimize hand hygiene (HH). Uptake of these recommendations by healthcare workers (HCWs) remains uncertain.

Methods.

We prospectively observed HCW compliance to 5MHH. After observations, eligible HCWs who consented to interviews completed surveys on factors associated with HH compliance based on constructs from the transtheoretical model of behavioral change (TTM) and the theory of planned behavior (TPB). Survey results were compared with observed HCW behaviors.

Results.

There were 968 observations among 123 HCWs, of whom 110 (89.4%) were female and 63 (51.3%) were nurses. The mean HH compliance for all 5MHH was 23.2% (95% confidence interval [CI], 18.1%-28.3%) by direct observation versus 82.4% (95% CI, 79.9%-84.9%) by self report. The HCW 5MHH compliance was associated with critical care unit encounters (P < .05), medicine unit encounters (P = 0.08, P <.001), immunocompromised patient encounters (P <. 05), and HCW prioritized patient advocacy (P <.001). Self-reported TTM stages of action or maintenance (P = .08) and the total TPB behavior score correlated with observed 5MHH (r = 0.21, P = .02) and with self-reported 5MHH compliance (r = 0.53, P < .001).

Conclusion.

Observed HCW compliance to 5MHH was associated with the type of hospital unit, type of provider-patient encounter, and theory-based behavioral measures of 5MHH commitment.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 34 , Issue 11 , November 2013 , pp. 1137 - 1145
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

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