Highlights
- •Compliance with the 5th moment for hand hygiene is lowest of the five moments.
- •We explored healthcare staffs' behaviour and perception of the 5th moment.
- •Analysis explored organisational and professional culture and individual beliefs.
- •Results can inform intervention development to improve hand hygiene compliance.
Background
The World Health Organization describes that there are 5 moments during a health care
encounter when hand hygiene should be performed. This research explores a number of
explanatory hypotheses to inform future intervention development with regard to improving
compliance with the fifth moment.
Methods
A sequential, mixed-methods study was conducted using nonparticipant observation and
a survey with focus groups informing the development of the questionnaire. A total
of 484 participants were observed and 410 returned a postobservation questionnaire;
a response rate of 85%. Analysis explored the role of organizational culture, professional
culture/practice, and individual-level variables in explaining compliance with the
fifth moment.
Results
Ninety-three percent of participants performed hand hygiene following the fifth moment.
Compliance varied between regions, but not by professional group. More than 65% indicated
that the fifth moment was clearly defined, achievable, valuable, encouraged, and widely
known. However, 60% suggested that it was repetitive. There was a positive relationship
between the performance of hand hygiene following the fifth moment and the perception
that it was widely known.
Conclusions
Interventions to improve compliance with the fifth moment should focus on promoting
awareness of the fifth moment and how it should be implemented in practice. Mechanisms
for raising awareness should include education and role modeling.
Key Words
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Article info
Publication history
Published online: February 05, 2016
Footnotes
Supported by the Scottish Infection Research Network.
Conflicts of Interest: None to report.
Identification
Copyright
© 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
