Increasing ICU Staff Handwashing: Effects of Education and Group Feedback

Dubbert, Patricia M.; Dolce, Jeffrey J.; Richter, William; Miller, Mary; Chapman, Stanley W.

doi:10.1086/646148

Cited by 166 publications

(140 citation statements)

References 7 publications

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“…Another finding was that some HCWs believed that they washed their hands when necessary, even when observations indicated that they did not. 24 Finally, some HCWs argued that the lack of scientific information of the definitive impact of improved hand hygiene on nosocomial infections rates decreases their motivation to comply with recommendations.…”

Section: Compliance W I T H H a N D H Y G I E N Ementioning

confidence: 99%

“…27 The most effective strategy documented so far has been routine observation and feedback. 18,24,37 In 1998, Kretzer and Larson 28 revisited the major behavioral theories and their applications with regard to the health professions in an attempt to understand better how one might plan more successful interventions. They proposed a hypothetical framework to enhance hand-hygiene practices and stressed the importance of considering the complexity of individual and institutional factors when designing behavioral interventions.…”

Section: Improving Compliance With Hand Hygienementioning

confidence: 99%

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Improving Compliance With Hand Hygiene in Hospitals

Pittet

2000

Infect. Control Hosp. Epidemiol.

469

279

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Hand hygiene prevents cross-infection in hospitals, but compliance with recommended instructions often is poor among healthcare workers. Although some previous interventions to improve compliance have been successful, none has achieved lasting improvement. This article reviews reported barriers to appropriate hand hygiene and factors associated with poor compliance.Easy access to hand hygiene in a timely fashion and the availability of skin-care lotion both appear to be necessary prerequisites for appropriate hand-hygiene behavior. In particular, in high-demand situations, hand rub with an alcohol-based solution appears to be the only alternative that allows a decent compliance. The hand-hygiene compliance level does not rely on individual factors alone, and the same can be said for its promotion. Because of the complexity of the process of change, it is not surprising that solo interventions often fail, and multimodal, multidisciplinary strategies are necessary. A framework that includes parameters to be considered for hand-hygiene promotion is proposed, based on epidemiologically driven evidence and review of the current knowledge. Strategies for promotion in hospitals should include reasons for noncompliance with recommendations at individual, group, and institutional levels. Potential tools for change should address each of these elements and consider their interactivity {Infect Control Hosp Epidemiol 2000;21:381-386).Hand hygiene is considered the most important measure to reduce the transmission of nosocomial pathogens in healthcare settings. As recently reviewed by Larson in a comprehensive article, 1 seven quasi-experimental hospitalbased studies of the impact of hand hygiene on the risk of nosocomial infection have been published between 1977 and 1995. 2 " 8 Despite study limitations, most reports showed a temporal relation between improved hand-hygiene practices and reduced infection rates. Similarly, the beneficial effects of hand-hygiene promotion on the risk of crosstransmission have been reported in surveys conducted in schools or day-care centers, 9 " 12 as well as in a community setting. 1315 Despite such evidence, studies in the literature have repeatedly documented that the importance of this simple procedure is not sufficiently recognized by healthcare workers (HCWs), 16 and compliance with recommended hand-hygiene practices is unacceptably low. 8,16 " 21 This article reviews factors that may explain the lack of adherence by HCWs to hand-hygiene procedures and suggests strategies for promotion in hospitals.

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Section: Compliance W I T H H a N D H Y G I E N Ementioning

confidence: 99%

Section: Improving Compliance With Hand Hygienementioning

confidence: 99%

Improving Compliance With Hand Hygiene in Hospitals

Pittet

2000

Infect. Control Hosp. Epidemiol.

469

279

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“…Reported reasons for not cleaning hands include skin irritation, inaccessible hand sanitation supplies, wearing gloves, being too busy, or not thinking about it. However, people commonly believe they cleaned their hands when necessary even when observations indicated otherwise (Dubbert, Dolce, Richter, Miller, & Chapman, 1990).…”

Section: Fundamental Concepts Underlying Hand Sanitation Practicesmentioning

confidence: 99%

Predicting and explaining behavioral intention and hand sanitizer use among US Army soldiers

Lin

Roberts

2017

American Journal of Infection Control

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Many pathogenic microorganisms are spread by contaminated hands and may lead to foodborne illness. The use of hand sanitizers can significantly reduce bacterial contamination and is an efficient and inexpensive method to prevent infections and sickness. Previous researchers have found that the routine use of hand sanitizers allowed the U.S. Army to significantly reduce illness. However, few studies have been conducted within a U.S. Army dining facility, which is considered to be one of the primary sources of foodborne illness within the U.S. Army. Therefore, using the Theory of Planned Behavior, the purpose of this study was to identify the behavioral intention, attitudes, subjective norms, and perceptions of control of using hand sanitizer among military personnel.The study targeted soldiers using a written survey during their lunch hour on the U.S.Army base at Fort Riley, KS. A total of 201 surveys were collected. All data were screened and entered into IBM SPSS for analysis.Results indicated that attitudes, subjective norms, and perceived behavioral control explained 64% of the variance in behavioral intention. Attitude and subjective norms were found to be significant predictors of behavioral intention, with attitude being the strongest predictor.In general, behavioral beliefs were positive among soldiers. Related to normative beliefs, soldiers did perceive negative social pressure from other soldiers not to use hand sanitizers.Analysis of control beliefs found soldiers perceived hand sanitizers were readily available, but disliked their smell and feel after application.Food production managers and Army commanders can use these results to implement hand sanitation behavioral interventions within military dining environments. Practical implications will likely translate to reduced healthcare costs, decreased absenteeism rates, and improved mission readiness.Some of the limitations include commonly perceived social psychology bias. Further, clustered samples were collected within one military installation in a relatively short amount of time.

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“…60,140,215,216,334,335,485,486,492,493,496,497,613,633,637,[648][649][650][651]654,655,657, It should be pointed out that the methods for defining adherence (or non-adherence) and the methods for conducting observations varied considerably in the reported studies, and many articles did not include detailed information about the methods and criteria used. Some studies assessed compliance with hand hygiene concerning the same patient, 60,334,648,652,666,667,683,[685][686][687] and an increasing number have recently evaluated hand hygiene compliance after contact with the patient environment. A number of investigators reported improved adherence after implementing various interventions, but most studies had short follow-up periods and did not establish if improvements were of long duration.…”

Section: Observed Adherence To Hand Cleansingmentioning

confidence: 99%