Behavioral determinants of hand hygiene compliance in intensive care units

  • De Wandel D
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Abstract

BACKGROUND: Although hand hygiene is the most effective measure for preventing cross-infection, overall compliance is poor among health care workers. OBJECTIVES: To identify and describe predictors and determinants of noncompliance with hand hygiene prescriptions in intensive care unit nurses by means of a questionnaire. METHODS: A questionnaire based on a behavioral theory model was filled out by 148 nurses working on a 40-bed intensive care unit in a university hospital. Subjects were asked to fill out the 56-item questionnaire twice within a 2- to 6-week period. During this period, no interventions to enforce hand hygiene occurred on the unit. RESULTS: Response rate for the test was 73% (108/148); response rate for the retest was 53% (57/108). The mean self-reported compliance rate was 84%. Factor analysis revealed 8 elementary factors potentially associated with compliance. Internal consistency of the scales was acceptable. Intraclass correlation was low (0.60) for 6 subscales. A low self-efficacy was independently associated with noncompliance (beta = .379; P = .001). After exclusion of this variable, a negative attitude toward time-related barriers was associated with noncompliance (beta = -.147; P < .001). CONCLUSIONS: Neither having good theoretical knowledge of hand hygiene guidelines nor social influence or moral perceptions had any predictive value relative to hand hygiene practice. A valid questionnaire to identify predictors and determinants of noncompliance with hand hygiene has been designed. Nurses reporting a poor self-efficacy or a poor attitude toward time-related barriers appear to be less compliant

Author-supplied keywords

  • Attitude to Health
  • Belgium
  • Compliance
  • Guidelines
  • Hand Hygiene
  • Health Behavior
  • Health Care
  • Intensive Care Units
  • Intervention
  • Methods
  • Nurses
  • OVID 3
  • Practice
  • Statistics
  • Theoretical
  • analysis
  • article
  • attitude
  • college
  • cross infection
  • cross infection/pc [Prevention]
  • disease transmission
  • factorial analysis
  • female
  • hand
  • hand washing
  • health
  • health care personnel
  • health care survey
  • health personnel attitude
  • hospital
  • hospital personnel
  • human
  • hygiene
  • infection control
  • intensive care
  • intensive care unit
  • internal consistency
  • knowledge
  • male
  • methodology
  • model
  • nurse
  • perception
  • practice guideline
  • predictive value
  • prescription
  • questionnaire
  • relative
  • reproducibility
  • skin care
  • standard
  • theory
  • university
  • university hospital
  • worker

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Authors

  • D.Maes De Wandel

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