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
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.