Qualitative findings from focus group discussions on hand hygiene compliance among health care workers in Vietnam

Salmon, Sharon; McLaws, Mary‐Louise

doi:10.1016/j.ajic.2015.05.039

Cited by 26 publications

(21 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some of the methods they suggested were not even evidence based as "leaving the patient bed/room for rest". Studies also indicated that some HCWs don't have the correct understanding of the importance of HH and personal beliefs about the efficiency of HH might be a barrier [5,9,13,15,29]. This perception is similar to the environmental/individual safety culture defined by Bernard et al [27,28].…”

Section: Discussionmentioning

confidence: 84%

“…HCWs practice inherent HH after touching an "emotionally dirty area" [6,9,15,23]. Self-protection which forms the basis for inherent behavior is the primary motive for HH among HCWs [6,9,15,18,20,23]. In contrast, HH occurs in more specific opportunities not encompassed in the inherent category.…”

Section: Discussionmentioning

confidence: 99%

“…Qualitative research methods can provide a deeper understanding of behavior since they explore beliefs, attitudes, social environment and intention [4]. Hence these methods are being increasingly used in studying compliance to HH guidelines [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Teker

Hıdıroğlu

et al. 2019

J Infect Dev Ctries

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Teker

Hıdıroğlu

et al. 2019

J Infect Dev Ctries

View full text Add to dashboard Cite

show abstract

“…The effectiveness of an intervention was also influenced by the characteristic of simplicity. Evidence shows that difficulty in understanding an intervention is one major reason of non-effective hand hygiene intervention [ 29 , 42 , 43 ]. This is because, with complex and unclear explanations about the intervention, nurses do not understand the rationale for performing all hand hygiene practices.…”

Section: Discussionmentioning

confidence: 99%

How to make hand hygiene interventions more attractive to nurses: A discrete choice experiment

Zhao

Yang

Huang³

et al. 2018

PLoS ONE

View full text Add to dashboard Cite

BackgroundBetter understanding of the characteristics of interventions which are attractive to nurses is required in order to implement effective hand hygiene interventions.MethodsThe intervention characteristics were derived from diffusion of innovation theory (DIT): relative advantage, compatibility, simplicity, trialability, and observability. To identify nurses’ preferences for the five characteristics, a discrete choice experiment (DCE) was conducted. Participants were nurses working at Taiwanese tertiary care hospitals selected through stratified sampling. In addition, the hand hygiene moment (before or after patient contact) was taken into consideration in the DCE to investigate whether nurses’ preferences for the intervention characteristics were the same at different hand hygiene moments.ResultsThis survey was conducted between 1 October and 31 December 2014. Among 200 nurses from three Taiwanese tertiary care hospitals, significant preferences for the five intervention characteristics were observed. That is, when an intervention makes the hand hygiene activity more convenient (p<0.001), when nurses participate in the design of the intervention (p<0.001), when an intervention is explained well to nurses before implementing it (p<0.001), when the evidence of hand hygiene is provided at a trial stage to show its effectiveness (p<0.001), and when nurses’ hand hygiene performance is observable to their peers (p<0.001), nurses are more willing to wash their hands with high compliance. In addition, nurses preferred for providing evidence at a trial stage most, and well explanation about the intervention to increase simplicity was least. The rankings of the preference for the five intervention characteristics were the same at different hand hygiene moments (p = 0.453)ConclusionsThe findings suggest policy directions for decision makers aiming to improve overall hand hygiene compliance in healthcare facilities.

show abstract

“…Several barriers to correct infection control practices that concur with other findings in developing countries included suboptimal provision of PPE materials and hand hygiene utilities [ 50 , 53 , 54 ]. In Vietnamese hospitals, inadequate supplies of masks resulted in re-use over one or more days and poor supplies of hand hygiene solutions was linked to poor hand hygiene [ 26 , 55 ]. The cost-effectiveness of hand hygiene program in reducing healthcare associated infections in intensive care units in Vietnam have been well demonstrated [ 56 ].…”

Section: Discussionmentioning

confidence: 99%

Dangerous practices in a hemodialysis unit in Vietnam identify from mixed methods

Duong

McLaws

2017

BMC Infect Dis

Self Cite

View full text Add to dashboard Cite

BackgroundNon-compliance with infection control practices poses a serious risk to patients receiving chronic hemodialysis. We aimed to identify the type and frequency of non-compliance with infection control practices in a hemodialysis unit in Vietnam where a large outbreak of hepatitis C infection had occurred.MethodsMixed methods approach included observations and discussions of non-compliance with all 12 nurses at the Hemodialysis Unit, District-6 Hospital in Ho Chi Minh City. Observations of nursing care activities were made between September 2013 and January 2014. Compliance with hand hygiene and glove use during nursing care activities were classified according to the potential for a serious risk of transmission of infection and reported as percentages. Each nurse was expected to provide 11 nursing care activities to three patients assigned per hemodialysis sessions. Activities were to be given on an individual patient-centered care basis, that is, one patient was to receive all 11 activities by their assigned nurse. On completion of the observations all nurses were enrolled in a focus group where observed non-compliance was discussed and transcripts were examined for themes.ResultsHand hygiene compliance rate was low (27%, 95%CI 25%-28%, 1633/6140) regardless of classification of seriousness of risk from this breach. Although glove use (76%, 95%CI 74-78%, 1211/1586) and other personal protective equipment use (81%, 95%CI 78%-83%, 773/959) were high gloves were observed to be reused with multiple patients during a single nursing care activity provided to consecutive patients. Nurses explained the breakdown of providing nursing care activities on an individual patient-centered basis was a response to limited supply of gloves and hand hygiene facilities and was exacerbated by nursing being co-opted by overly demanding patients to provide services without delay.ConclusionsThe adaption by the nurses to provide 11 single care activities to multiple consecutive patients in the absence of changing gloves and low hand hygiene compliance was potentially the central risk factor that facilitated the hepatitis C outbreak. Patient-centered care needs to be enforced to minimize multiple nurse-patient contacts that are associated with non-compliance classified as serious risk of infection transmission. Nurse empowerment to resist unreasonable patient demands may also be pivotal to assisting their compliance with hand hygiene and single patient-centered care. An audit program to measure infection control resources and practices may facilitate enforcement of the guidelines.

show abstract

Qualitative findings from focus group discussions on hand hygiene compliance among health care workers in Vietnam

Cited by 26 publications

References 22 publications

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

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

How to make hand hygiene interventions more attractive to nurses: A discrete choice experiment

Dangerous practices in a hemodialysis unit in Vietnam identify from mixed methods

Contact Info

Product

Resources

About