A qualitative study of hand hygiene compliance among health care workers in intensive care units

Abstract

Introduction: Studies indicate that adherence to hand hygiene guidelines is at suboptimal levels. We aimed to explore the reasons for poor hand hygiene compliance. Methodology: A qualitative study based on the Theory of Planned Behavior as a framework in explaining compliance, consisting four focus group discussions and six in-depth interviews. Results: Participants mostly practiced hand hygiene depending on the sense of "dirtiness" and "cleanliness". Some of the participants indicated that on-job training delivered by the infection control team changed their perception of "emotionally" based hand hygiene to "indication" based. Direct observations and individual feedback on one-to-one basis were the core of this training. There was low social cohesiveness and a deep polarization between the professional groups that led one group accusing the other for not being compliant. Conclusions: The infection control team should continue delivering one-to-one trainings based on observation and immediate feedback. But there is need to base this training model on a structured behavioral modification program and test its efficacy through a quasi-experimental design. Increasing social cohesiveness and transforming the blaming culture to a collaborative safety culture is also crucial to improve compliance. High workload, problems related to work-flow and turnover should be addressed.

Hand hygiene knowledge, perception and practice of healthcare workers in a Turkish university hospital intensive care unit

“…To explore the reasons for poor HH compliance we need to understand the beliefs and attitudes that shape HH behavior in our cultural setting [14,15]. A qualitative research has been planned and finalized to address these questions [16].…”

Adherence to Quarantine Protocols to Prevent the Spread of COVID-19: The Moderating Effect of Social Media Campaigns

“…Mo et al (2019) found that women engaged in compensated dating had a higher intention for future HIV testing when their peers were supportive of the behavior. Ay et al (2019) showed that the subjective norm of healthcare workers towards hand hygiene was influenced by social cohesiveness and a sense of belongingness with the Intensive Care Unit team. White et al (2015) found that Australian nurses reported that their colleagues influenced their normative beliefs towards hand hygiene the most.…”

Barriers to Hand Hygiene Compliance in Intensive Care Units From the Perspective of Healthcare Workers: A Qualitative Study

“…Qualitative research methods can be very helpful because they examine individuals' beliefs, attitudes, experiences and intentions [27]. Based on the review of literature, no qualitative study investigated this issue, so we decided to analyze the experiences and views of healthcare workers qualitatively and discover the barriers to hand hygiene practice in the southeastern Iran.…”