Healthcare workers’ hand decontamination practices

蓝鱼o_0

CREEDON S.A. (2005) Journal of Advanced Nursing 51(3), 208–216

Healthcare workers’ hand decontamination practices: compliance with recommended
guidelines
Aim. This paper reports a study of healthcare workers’ handwashing/hand hygiene
practices from a behavioural perspective.
Background. Hospital acquired infection poses a very real and serious threat to all
who are admitted to hospital. Pathogens are readily transmitted on healthcare
workers’ hands, and hand hygiene substantially reduces this transmission. Evidencebased
guidelines for healthcare workers’ hand hygiene practices exist, but compliance
with these is internationally low.
Methods. A quasi-experimental design with a convenient sample was used. The
Predisposing, Reinforcing, Enabling Constructs in Educational Diagnosis and
Evaluation Health Education Theory was used as the theoretical framework, and
the data were collected in 2001. Healthcare workers’ handwashing practices
(observation of behaviour, n ¼ 314) and their predisposition (attitudes, beliefs and
knowledge) towards compliance with hand hygiene guidelines (questionnaire,
n ¼ 62) were studied. Nurses, doctors, physiotherapists and care assistants involved
in direct patient care in the study unit participated in the study. The interventional
hand hygiene programme aimed to predispose healthcare workers to adopt hand
hygiene behaviour (poster campaign and educational handout), reinforce (feedback
on pretest results) and enable the behaviour (provision of an alcohol hand rub beside
each patients bedside).
Results. Implementation of the multifaceted interventional behavioural hand
hygiene programme resulted in an overall improvement in compliance with hand
hygiene guidelines (51–83%, P < 0&AElig;001). Furthermore, healthcare workers believed
that their skin condition improved (P < 0&AElig;001). An increase in knowledge about
handwashing guidelines was also found.
Conclusions. In order to be effective, efforts to improve compliance with handwashing
guidelines must be multifaceted. Alcohol hand rubs (with emollients) need
to be provided at each patient’s bedside. Issues surrounding healthcare workers’ skin
irritation need to be addressed urgently.