Using a theory of planned behaviour framework to explore hand hygiene beliefs at the ‘5 critical moments’ among Australian hospital-based nurses

Abstract

BackgroundImproving hand hygiene among health care workers (HCWs) is the single most effective intervention to reduce health care associated infections in hospitals. Understanding the cognitive determinants of hand hygiene decisions for HCWs with the greatest patient contact (nurses) is essential to improve compliance. The aim of this study was to explore hospital-based nurses’ beliefs associated with performing hand hygiene guided by the World Health Organization’s (WHO) 5 critical moments. Using the belief-base framework of the Theory of Planned Behaviour, we examined attitudinal, normative, and control beliefs underpinning nurses’ decisions to perform hand hygiene according to the recently implemented national guidelines.MethodsThematic content analysis of qualitative data from focus group discussions with hospital-based registered nurses from 5 wards across 3 hospitals in Queensland, Australia.ResultsImportant advantages (protection of patient and self), disadvantages (time, hand damage), referents (supportive: patients, colleagues; unsupportive: some doctors), barriers (being too busy, emergency situations), and facilitators (accessibility of sinks/products, training, reminders) were identified. There was some equivocation regarding the relative importance of hand washing following contact with patient surroundings.ConclusionsThe belief base of the theory of planned behaviour provided a useful framework to explore systematically the underlying beliefs of nurses’ hand hygiene decisions according to the 5 critical moments, allowing comparisons with previous belief studies. A commitment to improve nurses’ hand hygiene practice across the 5 moments should focus on individual strategies to combat distraction from other duties, peer-based initiatives to foster a sense of shared responsibility, and management-driven solutions to tackle staffing and resource issues. Hand hygiene following touching a patient’s surroundings continues to be reported as the most neglected opportunity for compliance.

Exploring Attitudes and Beliefs towards Implementing Cattle Disease Prevention and Control Measures: A Qualitative Study with Dairy Farmers in Great Britain

“…This model has been successfully applied to the development of behaviour change programmes for human health-associated behaviours, such as hand hygiene practices and sun protection measures [35,36,37] and, similarly, animal health-associated behaviours around conditions such as bovine mastitis [38]. Potentially, the TPB model could be utilised to assess what the most important barriers and motivators are to farmers undertaking biosecurity practices in order for targeted programmes to be developed to improve uptake of measures and subsequently enhance animal health and welfare.…”

Impacto de un programa de reducción de infección asociada a catéter en 9 unidades de cuidado intensivo pediátrico en Argentina

“…Está descrito que, cuando disminuye la vigilancia y las estrategias para mantener estas medidas, disminuye la adherencia y la tasa de infecciones vuelve a subir. [20][21][22] La alta rotación de personal, frecuente en las unidades de cuidados críticos, suma mayores dificultades a este desafío colectivo y hace necesario buscar nuevas estrategias de estímulo de manera permanente con el objetivo de lograr una mayor adherencia. El cambio fundamental consiste en lograr modificaciones en la cultura del personal de salud sobre la importancia de la higiene de manos y el cumplimiento de todos los puntos del programa por parte de todo el personal para alcanzar una reducción sostenida de las infecciones hospitalarias y continuar descendiendo las tasas de IAC actuales.…”

Intravaginal Practices in Female Sex Workers in Cambodia: A Qualitative Study

“…We used this theory to guide our qualitative analysis and to inform the development of future behavioral interventions on this matter. The qualitative approach to elicit salient culturally-specific constructs of theory of planned behavior has been used in previous health behavior studies, such as in hand hygiene practice (White et al, 2015), in HIV risk behaviors (Hutchinson et al, 2007), or in adherence to highly active antiretroviral therapy (Vissman et al, 2011). …”