Skip to main content
Top
Published in: BMC Public Health 1/2011

Open Access 01-12-2011 | Research article

Healthcare workers' and parents' perceptions of measures for improving adherence to hand-hygiene

Authors: Marta L Ciofi degli Atti, Alberto E Tozzi, Gaetano Ciliento, Manuel Pomponi, Silvia Rinaldi, Massimiliano Raponi

Published in: BMC Public Health | Issue 1/2011

Login to get access

Abstract

Background

This study was conducted to evaluate perceptions of healthcare workers (HCW) and parents regarding hand-hygiene and effectiveness of measures for increasing hand-hygiene adherence, in a children's hospital in Italy.

Methods

A cross-sectional study was performed from 5 to 13 July 2010, using two self-administered anonymous questionnaires (one for HCWs and one for parents/caregivers). The questionnaires included information regarding individual perceptions associated with hand hygiene.

Results

We collected 139 questionnaires from HCWs and 236 questionnaires from parents. Alcohol-based handrub was reported to be available at the point of care by 95.0% of the HCWs and in the child's room by 97.0% of the parents. For both HCWs and parents, availability of alcohol-based handrub was perceived as the most useful action for improving adherence to hand hygiene (scores ≥ 6 on a 7-point Likert-type scale: 84.8% [CI95%78.0-90.1] for HCWs and 87.9% [CI95% 83.3-91.7] for parents). Parents' reminding HCWs to perform hand hygiene was perceived as the least useful action (scores ≥ 6: 48.9% [CI95% 40.5-57.3] for HCWs and 55.7% [CI95% 49.2-62.1] for parents). Factors that affected HCWs' perceptions of the effectiveness of actions for improving adherence to hand hygiene included years of practice, type of ward and previous formal training on hand hygiene. For parents, factors affecting perceptions included previous information on hand hygiene and previous hospitalizations for their child.

Conclusions

Investigating HCWs' and parents' perceptions of measures for improving adherence can provide useful information for implementing actions for hand-hygiene promotion in children's hospitals. In this study, HCWs' and parents' perceptions were similar; alcohol-based hand-rub availability was perceived as the most useful tool, confirming its crucial role in multimodal interventions. Poor perception of inviting parents to remind HCWs to perform hand-hygiene has been previously observed, and deserves further investigation. Information and education activities were associated with more positive perceptions regarding various improvement measures. Though the relationship between perceptions and behaviours remains to be fully determined, HCWs should participate in formal training and families should be properly informed, not only to increase knowledge but also to improve perceptions on effectiveness of actions to be implemented.
Literature
1.
go back to reference Burke JP: Infection control - a problem for patient safety. N Engl J Med. 2003, 348 (7): 651-6. 10.1056/NEJMhpr020557.CrossRefPubMed Burke JP: Infection control - a problem for patient safety. N Engl J Med. 2003, 348 (7): 651-6. 10.1056/NEJMhpr020557.CrossRefPubMed
2.
go back to reference Pittet D, Allegranz B, Sax H, Bertinato L, Concia E, Cookson B, Fabry J, Richet H, Philip P, Spencer RC, Ganter BWK, Lazzari S: Considerations for a WHO European strategy on health-care-associated infection, surveillance, and control. Lancet Infect Dis. 2005, 5: 242-50. 10.1016/S1473-3099(05)70055-4.CrossRefPubMed Pittet D, Allegranz B, Sax H, Bertinato L, Concia E, Cookson B, Fabry J, Richet H, Philip P, Spencer RC, Ganter BWK, Lazzari S: Considerations for a WHO European strategy on health-care-associated infection, surveillance, and control. Lancet Infect Dis. 2005, 5: 242-50. 10.1016/S1473-3099(05)70055-4.CrossRefPubMed
3.
go back to reference WHO, Guidelines on hand hygiene in health care: First global patient safety challenge clean care is safer care. 2009 WHO, Guidelines on hand hygiene in health care: First global patient safety challenge clean care is safer care. 2009
4.
go back to reference Harbarth S, Sax H, Gastmeier P: The preventable proportion of nosocomial infections: an overview of published reports. J Hosp Infect. 2003, 54: 258-266. 10.1016/S0195-6701(03)00150-6.CrossRefPubMed Harbarth S, Sax H, Gastmeier P: The preventable proportion of nosocomial infections: an overview of published reports. J Hosp Infect. 2003, 54: 258-266. 10.1016/S0195-6701(03)00150-6.CrossRefPubMed
6.
go back to reference Pittet D, Simon A, Hugonnet S, Pessoa-Silva CL, Sauvan V, Perneger TV: Hand Hygiene among Physicians: Performance, Beliefs, and Perceptions. Ann Intern Med. 2004, 141: 1-8.CrossRefPubMed Pittet D, Simon A, Hugonnet S, Pessoa-Silva CL, Sauvan V, Perneger TV: Hand Hygiene among Physicians: Performance, Beliefs, and Perceptions. Ann Intern Med. 2004, 141: 1-8.CrossRefPubMed
7.
go back to reference Pittet D, Hugonnet S, Harbarth S, Mourouga P, Sauvan V, Touveneau S, Perneger TV, members of the Infection Control Programme: Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet. 2000, 356: 1307-1312. 10.1016/S0140-6736(00)02814-2.CrossRefPubMed Pittet D, Hugonnet S, Harbarth S, Mourouga P, Sauvan V, Touveneau S, Perneger TV, members of the Infection Control Programme: Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet. 2000, 356: 1307-1312. 10.1016/S0140-6736(00)02814-2.CrossRefPubMed
8.
go back to reference Bischoff WE, Reynolds TM, Sessler CN, Edmond MB, Wenzel RP: Handwashing compliance by health care workers: The impact of introducing an accessible, alcohol-based hand antiseptic. Arch Intern Med. 2000, 160: 1017-1021. 10.1001/archinte.160.7.1017.CrossRefPubMed Bischoff WE, Reynolds TM, Sessler CN, Edmond MB, Wenzel RP: Handwashing compliance by health care workers: The impact of introducing an accessible, alcohol-based hand antiseptic. Arch Intern Med. 2000, 160: 1017-1021. 10.1001/archinte.160.7.1017.CrossRefPubMed
9.
go back to reference Pittet D, Mourouga P, Perneger TV: Compliance with handwashing in a teaching hospital. Infection Control Program. Ann Intern Med. 1999, 130: 126-130.CrossRefPubMed Pittet D, Mourouga P, Perneger TV: Compliance with handwashing in a teaching hospital. Infection Control Program. Ann Intern Med. 1999, 130: 126-130.CrossRefPubMed
10.
go back to reference Pittet D: Improving compliance with hand hygiene in hospitals. Infect Control Hosp Epidemiol. 2000, 21: 381-386. 10.1086/501777.CrossRefPubMed Pittet D: Improving compliance with hand hygiene in hospitals. Infect Control Hosp Epidemiol. 2000, 21: 381-386. 10.1086/501777.CrossRefPubMed
11.
go back to reference McGuckin M, Taylor A, Martin V, Porten L, Salcido R: Evaluation of a patient education model for increasing hand hygiene compliance in an inpatient rehabilitation unit. Am J Infect Control. 2004, 32: 235-238. 10.1016/j.ajic.2003.10.005.CrossRefPubMed McGuckin M, Taylor A, Martin V, Porten L, Salcido R: Evaluation of a patient education model for increasing hand hygiene compliance in an inpatient rehabilitation unit. Am J Infect Control. 2004, 32: 235-238. 10.1016/j.ajic.2003.10.005.CrossRefPubMed
12.
go back to reference McGuckin M, Waterman R, Storr IJ, Bowler W, Ashby M, Topley K, Porten L: Evaluation of a patient empowering hand hygiene programme in the UK. J Hosp Infect. 2001, 48: 222-227. 10.1053/jhin.2001.0983.CrossRefPubMed McGuckin M, Waterman R, Storr IJ, Bowler W, Ashby M, Topley K, Porten L: Evaluation of a patient empowering hand hygiene programme in the UK. J Hosp Infect. 2001, 48: 222-227. 10.1053/jhin.2001.0983.CrossRefPubMed
13.
go back to reference Davis RE, Koutantji M, Vincent CA: How willing are patients to question healthcare staff on issues related to the quality and safety of their healthcare? An exploratory study. Qual Saf Health Care. 2008, 17: 90-96. 10.1136/qshc.2007.023754.CrossRefPubMed Davis RE, Koutantji M, Vincent CA: How willing are patients to question healthcare staff on issues related to the quality and safety of their healthcare? An exploratory study. Qual Saf Health Care. 2008, 17: 90-96. 10.1136/qshc.2007.023754.CrossRefPubMed
14.
go back to reference Fleming Carroll B, Matlow A, Dooley S, McDonald V, Meighan K, Streitenberger K: Patient safety in a pediatric centre: partnering with families. Healthc Q. 2006, 9: 96-101.CrossRefPubMed Fleming Carroll B, Matlow A, Dooley S, McDonald V, Meighan K, Streitenberger K: Patient safety in a pediatric centre: partnering with families. Healthc Q. 2006, 9: 96-101.CrossRefPubMed
16.
go back to reference Zaragoza M, Salles M, Gomez J, Bayas JM, Trilla A: Handwashing with soap or alcoholic solutions? A randomized clinical trial of its effectiveness. Am J Infect Control. 1999, 27 (3): 258-61. 10.1053/ic.1999.v27.a97622.CrossRefPubMed Zaragoza M, Salles M, Gomez J, Bayas JM, Trilla A: Handwashing with soap or alcoholic solutions? A randomized clinical trial of its effectiveness. Am J Infect Control. 1999, 27 (3): 258-61. 10.1053/ic.1999.v27.a97622.CrossRefPubMed
17.
go back to reference Maury E, Alzieu M, Baudel JL, Haram N, Barbut F, Guidet B, Offenstadt G: Availability of an alcohol solution can improve hand disinfection compliance in an intensive care unit. Am J Respir Crit Care Med. 2000, 162 (1): 324-7.CrossRefPubMed Maury E, Alzieu M, Baudel JL, Haram N, Barbut F, Guidet B, Offenstadt G: Availability of an alcohol solution can improve hand disinfection compliance in an intensive care unit. Am J Respir Crit Care Med. 2000, 162 (1): 324-7.CrossRefPubMed
18.
go back to reference Mody L, McNeil SA, Sun R, Bradley SE, Kauffman CA: Introduction of a waterless alcohol-based hand rub in a long-term-care facility. Infect Control Hosp Epidemiol. 2003, 24 (3): 165-71. 10.1086/502185.CrossRefPubMed Mody L, McNeil SA, Sun R, Bradley SE, Kauffman CA: Introduction of a waterless alcohol-based hand rub in a long-term-care facility. Infect Control Hosp Epidemiol. 2003, 24 (3): 165-71. 10.1086/502185.CrossRefPubMed
19.
go back to reference Girou E, Loyeau S, Legrand P, Oppein F, Brun-Buisson C: Efficacy of handrubbing with alcohol based solution versus standard handwashing with antiseptic soap: randomised clinical trial. BMJ. 2002, 325 (7360): 362-10.1136/bmj.325.7360.362.CrossRefPubMedPubMedCentral Girou E, Loyeau S, Legrand P, Oppein F, Brun-Buisson C: Efficacy of handrubbing with alcohol based solution versus standard handwashing with antiseptic soap: randomised clinical trial. BMJ. 2002, 325 (7360): 362-10.1136/bmj.325.7360.362.CrossRefPubMedPubMedCentral
20.
go back to reference World Health Organization. WHO global influenza preparedness plan: The role of WHO and recommendations for national measures before and during pandemics. 2005, WHO/CDS/CSR/GIP/2005.5 World Health Organization. WHO global influenza preparedness plan: The role of WHO and recommendations for national measures before and during pandemics. 2005, WHO/CDS/CSR/GIP/2005.5
21.
go back to reference Longtin Y, Sax H, Allegranzi B, Hugonnet S, Pittet D: Patients' beliefs and perceptions of their participation to increase healthcare worker compliance with hand hygiene. Infect Control Hosp Epidemiol. 2009, 30 (9): 830-9. 10.1086/599118.CrossRefPubMed Longtin Y, Sax H, Allegranzi B, Hugonnet S, Pittet D: Patients' beliefs and perceptions of their participation to increase healthcare worker compliance with hand hygiene. Infect Control Hosp Epidemiol. 2009, 30 (9): 830-9. 10.1086/599118.CrossRefPubMed
22.
go back to reference Duncanson V, Pearson LS: A study of the factors affecting the likelihood of patients participating in a campaign to improve staff hand hygiene. Br J Infect Control. 2005, 6: 26-30.CrossRef Duncanson V, Pearson LS: A study of the factors affecting the likelihood of patients participating in a campaign to improve staff hand hygiene. Br J Infect Control. 2005, 6: 26-30.CrossRef
23.
go back to reference Hibbard JH, Peters E, Slovic P, Tusler M: Can patients be part of the solution? Views on their role in preventing medical errors. Med Care Res Rev. 2005, 62 (5): 601-616. 10.1177/1077558705279313.CrossRefPubMed Hibbard JH, Peters E, Slovic P, Tusler M: Can patients be part of the solution? Views on their role in preventing medical errors. Med Care Res Rev. 2005, 62 (5): 601-616. 10.1177/1077558705279313.CrossRefPubMed
24.
go back to reference McGuckin M, Waterman R, Shubin A: Consumer attitudes about health care-acquired infections and hand hygiene. Am J Med Qual. 2006, 21 (5): 342-346. 10.1177/1062860606291328.CrossRefPubMed McGuckin M, Waterman R, Shubin A: Consumer attitudes about health care-acquired infections and hand hygiene. Am J Med Qual. 2006, 21 (5): 342-346. 10.1177/1062860606291328.CrossRefPubMed
25.
go back to reference National Patient Safety Agency: Achieving Our Aims: Evaluating the Results of the Pilot CleanyourHands Campaign. 2004, London, England: NPSA National Patient Safety Agency: Achieving Our Aims: Evaluating the Results of the Pilot CleanyourHands Campaign. 2004, London, England: NPSA
26.
go back to reference Balling K, McCubbin M: Hospitalized children with chronic illness: Parental caregiving needs and valuing parental expertise. J Ped Nursing. 2001, 16 (2): 110-119. 10.1053/jpdn.2001.23157.CrossRef Balling K, McCubbin M: Hospitalized children with chronic illness: Parental caregiving needs and valuing parental expertise. J Ped Nursing. 2001, 16 (2): 110-119. 10.1053/jpdn.2001.23157.CrossRef
27.
go back to reference McGuckin M, Waterman R, Porten L, Bello S, Caruso M, Juzaitis B, Krug E, Mazer S, Ostrawski S: Patient education model for increasing handwashing compliance. Am J Infect Control. 1999, 27 (4): 309-314. 10.1016/S0196-6553(99)70049-0.CrossRefPubMed McGuckin M, Waterman R, Porten L, Bello S, Caruso M, Juzaitis B, Krug E, Mazer S, Ostrawski S: Patient education model for increasing handwashing compliance. Am J Infect Control. 1999, 27 (4): 309-314. 10.1016/S0196-6553(99)70049-0.CrossRefPubMed
28.
go back to reference Ajzen I: Attitudes, Personality, and Behavior. 1988, Chicago, IL: Dorsey, 26-Ronk LL Ajzen I: Attitudes, Personality, and Behavior. 1988, Chicago, IL: Dorsey, 26-Ronk LL
29.
go back to reference Girard NJ: Risk perception, universal precautions compliance: a descriptive study of nurses who circulate. AORN J. 1994, 59: 253-266. 10.1016/S0001-2092(07)65325-3.CrossRefPubMed Girard NJ: Risk perception, universal precautions compliance: a descriptive study of nurses who circulate. AORN J. 1994, 59: 253-266. 10.1016/S0001-2092(07)65325-3.CrossRefPubMed
30.
go back to reference Broughall JM, Marshman C, Jackson B, Bird P: An automatic monitoring system for measuring handwashing frequency in hospital wards. J Hosp Infect. 1984, 5: 447-45333. 10.1016/0195-6701(84)90016-1.CrossRefPubMed Broughall JM, Marshman C, Jackson B, Bird P: An automatic monitoring system for measuring handwashing frequency in hospital wards. J Hosp Infect. 1984, 5: 447-45333. 10.1016/0195-6701(84)90016-1.CrossRefPubMed
31.
go back to reference McLane C, Chenelly S, Sylwestrak ML, Kirchhoff KT: A nursing practice problem: failure to observe aseptic technique. Am J Infect Control. 1983, 11: 178-182. 10.1016/0196-6553(83)90078-0.CrossRefPubMed McLane C, Chenelly S, Sylwestrak ML, Kirchhoff KT: A nursing practice problem: failure to observe aseptic technique. Am J Infect Control. 1983, 11: 178-182. 10.1016/0196-6553(83)90078-0.CrossRefPubMed
32.
go back to reference Rutter D, Quine L, eds: Changing health behaviour: intervention and research with social cognition models. 2002, Open University Press Rutter D, Quine L, eds: Changing health behaviour: intervention and research with social cognition models. 2002, Open University Press
33.
go back to reference Burnett E: Perceptions, attitudes, and behaviour towards patient hand hygiene. Am J Infect Control. 2009, 37 (8): 638-42. 10.1016/j.ajic.2009.04.281.CrossRefPubMed Burnett E: Perceptions, attitudes, and behaviour towards patient hand hygiene. Am J Infect Control. 2009, 37 (8): 638-42. 10.1016/j.ajic.2009.04.281.CrossRefPubMed
Metadata
Title
Healthcare workers' and parents' perceptions of measures for improving adherence to hand-hygiene
Authors
Marta L Ciofi degli Atti
Alberto E Tozzi
Gaetano Ciliento
Manuel Pomponi
Silvia Rinaldi
Massimiliano Raponi
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2011
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-11-466

Other articles of this Issue 1/2011

BMC Public Health 1/2011 Go to the issue