Highlights
- •Self-reported patient hand hygiene rates are suboptimal.
- •There are knowledge gaps among patients as to when to perform hand hygiene.
- •Patients are not receptive to receiving traditional educational interventions.
- •Intervention foci may include bedside hand sanitizer, reminders, or role modeling.
Background
Pathogens may be transmitted in hospitals via patients’ own hands, but little is known
about the facilitators and barriers of hand hygiene among inpatients. This study aimed
to assess the hand hygiene knowledge, attitudes, and practices of adult inpatients
at 5 hospitals.
Methods
The study consisted of a cross-sectional survey distributed followed by structured
interviews with randomly selected inpatients. Qualitative data were analyzed independently
by 2 researchers using the Theoretical Domains Framework.
Results
A total of 268 surveys were completed, with 66.4% of patients reporting always performing
hand hygiene after toileting and 49.2% before eating. The majority of patients (74.6%)
stated that they did not want to receive more information about hand hygiene while
in the hospital. Key themes identified from 23 interviews include knowledge; environmental
context and resources; memory, attention, and decision processes; and social influences.
Conclusions
Self-reported patient hand hygiene rates are suboptimal and there are knowledge gaps
among patients as to when to perform hand hygiene, but patients are not receptive
to receiving traditional educational interventions. Future interventions to improve
patient hand hygiene should focus on other behavior change domains, including environmental
context and resources (eg, access to hand sanitizer at the bedside), memory, attention,
and decision processes (eg, posters or other reminders), and social influences (eg,
role modeling).
Key Words
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Article Info
Publication History
Published online: December 27, 2019
Footnotes
Funding/support: This study was funded by a Hamilton Health Sciences Quality and Patient Safety Grant.
Conflicts of interest: None to report.
Identification
Copyright
© 2019 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
