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The influence of observational hand hygiene auditing on consultant doctors’ hand hygiene behaviors: A qualitative study

Published on Jan 1, 2019in American Journal of Infection Control1.97
· DOI :10.1016/j.ajic.2018.12.024
Maura P. Smiddy2
Estimated H-index: 2
(UCC: University College Cork),
Olive M. Murphy1
Estimated H-index: 1
(Bon Secours Hospital Cork)
+ 1 AuthorsJohn Browne34
Estimated H-index: 34
(UCC: University College Cork)
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Abstract
Background Compliance with hand hygiene guidelines reduces the risk of health care–associated infection, yet doctors are less compliant than other health care workers. Use of observational hand hygiene auditing with targeted individualized feedback was implemented, with improved hand hygiene of consultant doctors; however, the factors that influenced this were not explained by previous quantitative data. The aim was to explore consultant doctors’ opinions about the influence of observational hand hygiene auditing with individualized feedback on hand hygiene behavior. Methods Using the Theoretical Domains Framework, we conducted 12 semi-structured in-depth interviews with consultant doctors who experienced the observational hand hygiene audit and feedback intervention. Data were analyzed using a thematic analysis approach. Results Analysis identified 8 domains of the Theoretical Domains Framework, with 5 dominant domains: (1) behavioral regulation: receiving written individualized audit feedback positively influenced practice; (2) knowledge: provision of specific individualized feedback improved performance; (3) reinforcement: audit highlighted substandard practices; (4) social professional role and identity: audit reports triggered profession-associated competitive motivation; and (5) environmental context and resources: auditing was perceived to be synonymous with strong organizational safety culture. Conclusions In this study, provision of individualized targeted feedback was a critical component of observational hand hygiene auditing.
  • References (31)
  • Citations (1)
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References31
Newest
Published on May 1, 2017in American Journal of Infection Control1.97
Jun Rong Jeffrey Neo1
Estimated H-index: 1
(Cornell University)
Health care–associated infection is a leading cause of morbidity and mortality. Hand hygiene is widely regarded as an effective prevention strategy. Often, hand hygiene research is designed and conducted by health care practitioners who may lack formal training in research methods, particularly in the area of social science. In a research context, a construct is a concept that can be measured or observed in some way. A construct can be directly or indirectly measured. For example, height can be ...
Published on Feb 1, 2017in American Journal of Infection Control1.97
Karen Slater3
Estimated H-index: 3
(Princess Alexandra Hospital),
Marie Cooke23
Estimated H-index: 23
+ 1 AuthorsMichael Whitby28
Estimated H-index: 28
Published on Jul 1, 2016in American Journal of Infection Control1.97
Syed Azim6
Estimated H-index: 6
(UNSW: University of New South Wales),
C. Juergens16
Estimated H-index: 16
(Liverpool Hospital),
Mary-Louise McLaws Dtmh Mph36
Estimated H-index: 36
(UNSW: University of New South Wales)
Background To understand whether the burden of hand hygiene contributes to poor compliance we measured the daily number of hand hygiene opportunities (HHOs) by shift for nurses and physicians in 2 wards in a 850-bed university teaching hospital. Methods On each ward 4 trained auditors collected the number of HHOs and compliance events for 24 hours over 7 days. Twenty-one thousand four hundred fifty HHOs were collected from a medical and a surgical ward. The proportion of alcohol-based handrub us...
Published on Apr 1, 2016in Journal of Hospital Infection3.70
Liz M. Kingston3
Estimated H-index: 3
(UL: University of Limerick),
Nuala H. O'Connell6
Estimated H-index: 6
(UL: University of Limerick),
Colum P. Dunne29
Estimated H-index: 29
(UL: University of Limerick)
Summary Considerable emphasis is currently placed on reducing healthcare-associated infection through improving hand hygiene compliance among healthcare professionals. There is also increasing discussion in the lay media of perceived poor hand hygiene compliance among healthcare staff. Our aim was to report the outcomes of a systematic search for peer-reviewed, published studies – especially clinical trials – that focused on hand hygiene compliance among healthcare professionals. Literature publ...
Published on Dec 1, 2015in Critical Care6.96
John Adam Reich1
Estimated H-index: 1
(Tufts University),
Monica E. Goodstein1
Estimated H-index: 1
(Tufts University)
+ 5 AuthorsStanley A. Nasraway35
Estimated H-index: 35
(Tufts University)
Introduction Hand hygiene is an effective, low-cost intervention that prevents the spread of multidrug-resistant bacteria. Despite mandatory education and reminders, compliance by physicians in our hospital remained stubbornly low. Our objective was to study whether surveillance by our unit coordinator (secretary) paired with regular feedback to chiefs of service would increase physician hand hygiene compliance in the ICU.
Published on Jul 28, 2015in BMJ27.60
Nantasit Luangasanatip4
Estimated H-index: 4
(MU: Mahidol University),
Maliwan Hongsuwan9
Estimated H-index: 9
(MU: Mahidol University)
+ 6 AuthorsB. D. Cooper69
Estimated H-index: 69
(MU: Mahidol University)
Objective To evaluate the relative efficacy of the World Health Organization 2005 campaign (WHO-5) and other interventions to promote hand hygiene among healthcare workers in hospital settings and to summarize associated information on use of resources. Design Systematic review and network meta-analysis. Data sources Medline, Embase, CINAHL, NHS Economic Evaluation Database, NHS Centre for Reviews and Dissemination, Cochrane Library, and the EPOC register (December 2009 to February 2014); studie...
Published on Mar 1, 2015in BMJ Quality & Safety7.04
Frank Davidoff36
Estimated H-index: 36
(Dartmouth College),
Mary Dixon-Woods51
Estimated H-index: 51
(University of Leicester)
+ 1 AuthorsSusan Michie73
Estimated H-index: 73
(UCL: University College London)
The role and value of theory in improvement work in healthcare has been seriously underrecognised. We join others in proposing that more informed use of theory can strengthen improvement programmes and facilitate the evaluation of their effectiveness. Many professionals, including improvement practitioners, are unfortunately mystified—and alienated—by theory, which discourages them from using it in their work. In an effort to demystify theory we make the point in this paper that, far from being ...
Published on Mar 1, 2015in American Journal of Infection Control1.97
Maura P. Smiddy2
Estimated H-index: 2
(UCC: University College Cork),
Rhona O’Connell5
Estimated H-index: 5
(UCC: University College Cork),
Sile A. Creedon7
Estimated H-index: 7
(UCC: University College Cork)
Background Acquisition of a health care–associated infection is a substantial risk to patient safety. When health care workers comply with hand hygiene guidelines, it reduces this risk. Despite a growing body of qualitative research in this area, a review of the qualitative literature has not been published. Methods A systematic review of the qualitative literature. Results The results were themed by the factors that health care workers identified as contributing to their compliance with hand hy...
Published on Feb 1, 2015in Lancet Infectious Diseases27.52
Walter Zingg19
Estimated H-index: 19
(University of Geneva),
Alison Holmes28
Estimated H-index: 28
(Imperial College London)
+ 6 AuthorsDidier Pittet95
Estimated H-index: 95
(University of Geneva)
Summary Despite control efforts, the burden of health-care-associated infections in Europe is high and leads to around 37 000 deaths each year. We did a systematic review to identify crucial elements for the organisation of effective infection-prevention programmes in hospitals and key components for implementation of monitoring. 92 studies published from 1996 to 2012 were assessed and ten key components identified: organisation of infection control at the hospital level; bed occupancy, staffing...
Published on Dec 17, 2014in JAMA51.27
Jeffrey S. Gerber23
Estimated H-index: 23
(Children's Hospital of Philadelphia),
Priya A. Prasad19
Estimated H-index: 19
(Children's Hospital of Philadelphia)
+ 4 AuthorsTheoklis E. Zaoutis54
Estimated H-index: 54
(Children's Hospital of Philadelphia)
Cited By1
Newest
Published on Apr 2, 2019in Journal of Infection Prevention
Maura P. Smiddy2
Estimated H-index: 2
(NUI: National University of Ireland),
Olive M. Murphy1
Estimated H-index: 1
(Bon Secours Hospital Cork)
+ 5 AuthorsJohn Browne34
Estimated H-index: 34
(Bon Secours Hospital Cork)
Background:Healthcare-associated infection compromises patient safety. Compliance with hand hygiene (HH) guidelines has been shown to be an effective method of reducing infection; however, it remai...