WHO Guidelines on Hand Hygiene in Health Care - Safe Care ...

PART I. REVIEW OF SCIENTIFIC DATA RELATED TO HAND HYGIENE
Table I.16.3
Factors influencing adherence to hand hygiene practices (Cont.)
Factors for poor adherence / low compliance
References
C. Additional perceived barriers to appropriate hand hygiene
Lack of active participation in hand hygiene promotion at individual or institutional
level
Larson & Kretzer, 1995 722
Kretzer & Larson, 1998 724
Larson et al., 2000 713
Pittet, 2000 738
Pittet et al., 2000 60
Pittet & Boyce, 2001 749
Pittet, 2001 750
Lack of institutional priority for hand hygiene Pittet, 2000 738
Pittet et al., 2000 60
Pittet, 2001 750
Lack of administrative sanction of non-compliers or rewarding of compliers Kelen et al., 1991 751
Jarvis, 1994 721
Kretzer & Larson, 1998 724
Boyce, Kelliher & Vallande, 2000 264
Pittet, 2000 738
Pittet & Boyce, 2001 749
Pittet, 2001 750
Lack of institutional safety climate/ culture of personal accountability of HCWs to
perform hand hygiene
Factors for good adherence/ improved compliance
Larson & Kretzer, 1995 722
Kretzer & Larson, 1998 724
Larson et al., 2000 713
Pittet, 2000 738
Pittet et al., 2000 60
Pittet & Boyce, 2001 749
Pittet, 2001 750
Goldmann, 2006 752
References
A. Observed factors for improved compliance
Introduction of widely accessible alcohol-based handrub
(e.g. bedside handrub, small bottles/pocket-sized handrub); or combined with a
multimodal multidisciplinary approach targeted at individual and institution levels.
Multifaceted approach to improve hand hygiene
(e.g. education, training, observation, feedback, easy access to hand hygiene supplies
(sinks/ soap/ medicated detergents), sink automation, financial incentives, praises
by superior, admonishment of suboptimal performance, administrative support,
prioritization to infection control needs, active participation at institutional level)
Pittet & Perneger, 1999 737
Bischoff et al., 2000 486
Maury, 2000 485
Pittet et al., 2000 60
Earl, 2001 753
Girard, Amazian & Fabry, 2001 613
Harbarth et al., 2002 686
Hugonnet, Perneger & Pittet, 2002 334
Mody et al., 2003 754
Brown et al., 2003 687
Lam, Lee & Lau, 2004 648
Pittet et al., 2004 335
Johnson et al., 2005 494
Zerr et al., 2005 715
Hussein, Khakoo & Hobbs, 2007 755
Pessoa-Silva et al., 2007 657
Trick et al., 2007 701
Rupp et al., 2008 707
Conly et al., 1989 663
Dubbert et al., 1990 666
Larson et al., 1997 684
Rosenthal et al., 2003 651
Won et al., 2004 756
Rosenthal, Guzman & Safdar, 2005 716
B. Predictive factors for hand hygiene compliance (by observational study / interventional study*)
(i) Status of HCW
Non-doctor HCW status (with attending doctors as reference group) Duggan et al., 2008 711
75