Behavioural considerations for hand hygiene practices: the basic building blocks

Whitby, Michael; Pessoa-Silva, Carmen Lúcia; McLaws, Mary‐Louise; Allegranzi, Benedetta; Sax, Hugo; Larson, Elaine; Seto, W. H.; Donaldson, Liam; Pittet, Didier

doi:10.1016/j.jhin.2006.09.026

Cited by 268 publications

(230 citation statements)

References 35 publications

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“…1,5,7,10 These findings suggest that behavioral determinants such as attitude, social influence, and self-efficacy may play a crucial role in compliance. A recent study by Whitby et al 11 underlines the importance of understanding the dynamics of behavioral change in order to design a strategy to improve hand hygiene compliance. …”

Section: Questionnaire Developmentmentioning

confidence: 99%

“…Furthermore, in our study, social influence had no predictive value. According to Whitby et al, 11 a focus on role modeling, peer pressure, education of health care workers, and ongoing "cues to action," such as posters or easy access to hand rubs can lead to persistent behavioral change.…”

Section: Analysis Of Behavioral Determinantsmentioning

confidence: 99%

“…44,45 According to Larson et al, 46 focusing on knowledge in order to improve one's attitude should not be effective. Recently a study 11 showed that feelings of unpleasantness, discomfort, and/or disgust lead to emotional sensations that invoke self-protection and therefore can help in improving one's attitude toward good hand hygiene practice.Social Influence. The answers indicate an overall neutral to positive ruling social norm.…”

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confidence: 99%

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Behavioral Determinants of Hand Hygiene Compliance in Intensive Care Units

Wandel¹,

Maes²,

Labeau³

et al. 2010

American Journal of Critical Care

134

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Background Although hand hygiene is the most effective measure for preventing cross-infection, overall compliance is poor among health care workers. Objectives To identify and describe predictors and determinants of noncompliance with hand hygiene prescriptions in intensive care unit nurses by means of a questionnaire. Methods A questionnaire based on a behavioral theory model was filled out by 148 nurses working on a 40-bed intensive care unit in a university hospital. Subjects were asked to fill out the 56-item questionnaire twice within a 2-to 6-week period. During this period, no interventions to enforce hand hygiene occurred on the unit. Results Response rate for the test was 73% (108/148); response rate for the retest was 53% (57/108). The mean self-reported compliance rate was 84%. Factor analysis revealed 8 elementary factors potentially associated with compliance. Internal consistency of the scales was acceptable. Intraclass correlation was low (<0.60) for 2 subscales but acceptable (>0.60) for 6 subscales. A low self-efficacy was independently associated with noncompliance (β = .379; P = .001). After exclusion of this variable, a negative attitude toward time-related barriers was associated with noncompliance (β = -.147; P < .001). Conclusions Neither having good theoretical knowledge of hand hygiene guidelines nor social influence or moral perceptions had any predictive value relative to hand hygiene practice. A valid questionnaire to identify predictors and determinants of noncompliance with hand hygiene has been designed. Nurses reporting a poor self-efficacy or a poor attitude toward time-related barriers appear to be less compliant. (American Journal of Critical Care. 2010;19:230-240) BEHAVIORAL DETERMINANTS OF HAND HYGIENE COMPLIANCE IN INTENSIVE CARE UNITS C E 1.0 Hour Notice to CE enrollees:A closed-book, multiple-choice examination following this article tests your under standing of the following objectives:1. Recognize the impact of behavioral determinants on compliance with hand hygiene recommendations. 2. Describe determinants of noncompliance with hand hygiene prescriptions among nurses in a general intensive care unit. 3. Understand how a low self-efficacy and a negative attitude toward time-related barriers are predictors of poor compliance with hand hygiene recommendations. In accordance with the attitude-social influenceself-efficacy model, 12 which combines Fishbein and Ajzen's theory of reasoned action 13 and Bandura's social learning theory, 14 attitude, social influence, and self-efficacy are valid concepts in predicting one's intention to change one's behavior or even one's actual change in behavior. 15,16 Attitude is primordially based on earlier experiences: behavior that has led to success will be reinforced and vice versa. Although one's general attitude toward a certain behavior is often the result of success and failure (or perceived advantage and disadvantage), not all attitudes are based on reason and logical sense. Some attitudes can be very rigid and based on highly ...

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Section: Questionnaire Developmentmentioning

confidence: 99%

Section: Analysis Of Behavioral Determinantsmentioning

confidence: 99%

mentioning

confidence: 99%

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Behavioral Determinants of Hand Hygiene Compliance in Intensive Care Units

Wandel¹,

Maes²,

Labeau³

et al. 2010

American Journal of Critical Care

134

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“…According to behavioural theories 725,767 (see Part I, Section 18), hand cleansing patterns are most likely to be established in the first 10 years of life. This imprinting subsequently affects the attitude to hand cleansing throughout life, in particular, regarding the practice called "inherent hand hygiene, 725,767 which reflects the instinctive need to remove dirt from the skin.…”

Section: Importance Of Hand Hygiene In Different Religionsmentioning

confidence: 99%

Hand Hygiene

Longtin¹,

Sax²,

Allegranzi³

et al. 2011

N Engl J Med

108

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“…Inherent community and home hand-washing practices are a predictor of in-hospital hand-washing behavior, 6 " 8 which means that, in hospitals, hand hygiene will be performed as one learns at home: one cleans one's hands after they become visibly soiled-in other words, an action to protect oneself. This was the message people received from television: "protect yourself," not "protect your patient."…”

mentioning

confidence: 99%