Pinar Ay1, Ayse Gulsen Teker2, Seyhan Hidiroglu3, Pinar Tepe4, Aysen Surmen5, Uluhan Sili6, Volkan Korten7, Melda Karavus8. 1. Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey. npay@marmara.edu.tr. 2. Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey. agulsenteker@hotmail.com. 3. Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey. seyhanerginh@gmail.com. 4. Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey. p.akinci80@gmail.com. 5. Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey. aysurmen@hotmail.com. 6. Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey. uluhan@hotmail.com. 7. Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey. vkorten@gmail.com. 8. Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey. meldak@marmara.edu.tr.
Abstract
INTRODUCTION: Studies indicate that adherence to hand hygiene guidelines is at suboptimal levels. We aimed to explore the reasons for poor hand hygiene compliance. METHODOLOGY: A qualitative study based on the Theory of Planned Behavior as a framework in explaining compliance, consisting four focus group discussions and six in-depth interviews. RESULTS: Participants mostly practiced hand hygiene depending on the sense of "dirtiness" and "cleanliness". Some of the participants indicated that on-job training delivered by the infection control team changed their perception of "emotionally" based hand hygiene to "indication" based. Direct observations and individual feedback on one-to-one basis were the core of this training. There was low social cohesiveness and a deep polarization between the professional groups that led one group accusing the other for not being compliant. CONCLUSIONS: The infection control team should continue delivering one-to-one trainings based on observation and immediate feedback. But there is need to base this training model on a structured behavioral modification program and test its efficacy through a quasi-experimental design. Increasing social cohesiveness and transforming the blaming culture to a collaborative safety culture is also crucial to improve compliance. High workload, problems related to work-flow and turnover should be addressed. Copyright (c) 2019 Pinar Ay, Ayse Gulsen Teker, Seyhan Hidiroglu, Pinar Tepe, Aysen Surmen, Uluhan Sili, Volkan Korten, Melda Karavus.
INTRODUCTION: Studies indicate that adherence to hand hygiene guidelines is at suboptimal levels. We aimed to explore the reasons for poor hand hygiene compliance. METHODOLOGY: A qualitative study based on the Theory of Planned Behavior as a framework in explaining compliance, consisting four focus group discussions and six in-depth interviews. RESULTS:Participants mostly practiced hand hygiene depending on the sense of "dirtiness" and "cleanliness". Some of the participants indicated that on-job training delivered by the infection control team changed their perception of "emotionally" based hand hygiene to "indication" based. Direct observations and individual feedback on one-to-one basis were the core of this training. There was low social cohesiveness and a deep polarization between the professional groups that led one group accusing the other for not being compliant. CONCLUSIONS: The infection control team should continue delivering one-to-one trainings based on observation and immediate feedback. But there is need to base this training model on a structured behavioral modification program and test its efficacy through a quasi-experimental design. Increasing social cohesiveness and transforming the blaming culture to a collaborative safety culture is also crucial to improve compliance. High workload, problems related to work-flow and turnover should be addressed. Copyright (c) 2019 Pinar Ay, Ayse Gulsen Teker, Seyhan Hidiroglu, Pinar Tepe, Aysen Surmen, Uluhan Sili, Volkan Korten, Melda Karavus.
Entities:
Keywords:
Hand hygiene compliance; healthcare-associated infections; intensive care unit; qualitative study
Authors: Adil Abalkhail; Ilias Mahmud; Fahad A Alhumaydhi; Thamer Alslamah; Ameen S S Alwashmi; Divya Vinnakota; Russell Kabir Journal: Healthcare (Basel) Date: 2021-11-24