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

<strong>WHO</strong> GUIDELINES ON HAND HYGIENE IN HEALTH CARE
Table I.16.3
Factors influencing adherence to hand hygiene practices (Cont.)
Factors for good adherence/ improved compliance
References
Respiratory therapist (with nurses as reference group) Harbarth et al., 2001 653
Harbarth et al., 2002 686
(ii) Type of patient care
Under precaution care (perceived as greater risk of transmission to HCWs themselves)
• care of patient under contact precautions
• care of patient in isolation room
Dedrick et al., 2007 702
Swoboda et al., 2007 699
Completing care/ between patients Pessoa-Silva et al., 2007 657
(iii) Activities perceived as having a high risk of cross-contamination or crossinfection
to HCWs
(e.g. after direct patient contact; before wound care; before/after contact with invasive
devices or aseptic techniques; before/after contact with body fluid secretions;
contact with nappies/diapers; or assessed by level of dirtiness of tasks)
(iv) Type of unit
• Intensive care unit
• Neonatal ICU
• Acute haemiodialysis unit
Lipsett & Swoboda, 2001 730
Harbarth et al., 2001 653
Harbarth et al., 2002 686
Kuzu et al., 2005 683
Jenner et al., 2006 700
Pessoa-Silva et al., 2007 657
Trick et al., 2007 701
Haas & Larson, 2008 709
Novoa et al., 2007 700
Harbarth et al., 2001 653
Arenas et al., 2005 689
(v) During the 3-month period after an announced accreditation visit Duggan et al., 2008 711
(vi) Strong administrative support Rosenthal et al., 2003 651
C. Determinants/ predictors/ self-reported factors for good adherence to hand hygiene (by questionnaire or focus group study)
Normative beliefs
Peer behaviour (role model)/
perceived expectation from colleagues (peer pressure)
Being perceived as role model (for doctors)/
with good adherence by colleagues
Perceived positive opinion / pressure from superior or important referent others e.g.
senior doctors, administrators
Wong & Tam, 2005 757
Whitby, McLaws & Ross, 2006 725
Sax et al., 2007 732
Pittet et al., 2004 335
Seto et al., 1991 758
Pittet et al., 2004 335
Pessoa-Silva et al., 2005 731
Whitby, McLaws & Ross, 2006 725
Sax et al., 2007 732
Control beliefs
Perception that hand hygiene is easy to perform/ easy access to alcohol-based
handrub
Pittet et al., 2004 335
Sax et al., 2007 732
Perceived control over hand hygiene behaviour Pessoa-Silva et al., 2005 731
Attitudes
Awareness of being observed Pittet et al., 2004 335
Positive attitude towards hand hygiene after patient contact Pittet et al., 2004 335
Perceived risk of infection (level of dirtiness) during patient contact/ perceived high
public health threat
Parker et al., 2006 254
Whitby, McLaws & Ross, 2006 725
Beliefs in benefits of performing hand hygiene/ protection of HCWs from infection Shimokura et al., 2006 759
Whitby, McLaws & Ross, 2006 725
Translation of community hand washing behaviour (behaviour developed in early
childhood) into healthcare settings (for nurses in handwashing)
Whitby, McLaws & Ross, 2006 725
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