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

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<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 76
PART I. REVIEW OF SCIENTIFIC DATA RELATED TO HAND HYGIENE Table I.16.3 Factors influencing adherence to hand hygiene practices (Cont.) Factors for good adherence/ improved compliance References Others Female sex Sax et al., 2007 732 HCW status – technician Shimokura et al., 2006 759 Previous training Sax et al., 2007 732 Participation in previous hand hygiene campaign Sax et al., 2007 732 Patient expectation (for doctors) Sax et al., 2007 732 D. Factors for preferential recourse to handrubbing vs handwashing Doctors e.g. critical care (with nurses as reference group) Pittet et al., 2000 60 Hugonnet, Perneger & Pittet, 2002 334 Dedrick et al., 2007 702 Trick et al., 2007 701 Activities with high risk of cross-transmission/ level of dirtiness Hugonnet, Perneger & Pittet, 2002 334 Kuzu et al., 2005 683 High activity index (>60 opportunities per hour) Hugonnet, Perneger & Pittet, 2002 334 77
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PART II. CONSENSUS RECOMMENDATIONS
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PART III. PROCESS AND OUTCOME MEASU
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PART IV. TOWARDS A GENERAL MODEL OF
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PART V. PATIENT INVOLVEMENT IN HAND
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PART VI. COMPARISON OF NATIONAL AND
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REFERENCES 35. Jroundi I et al. Pre
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REFERENCES 177. McBryde ES, Pettitt
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REFERENCES 400. McMurry LM, McDermo
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REFERENCES 468. Martin LS, McDougal
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REFERENCES 542. Wheelock SM, Lookin
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REFERENCES 615. Voss A, Widmer AF.
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REFERENCES 690. Saba R et al. Hand
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REFERENCES 765. Lee B, Newberg A. R
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REFERENCES 841. Gillet P. Construir
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REFERENCES 915. De Groot-Kosolcharo
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REFERENCES 986. Kinsella G, Thomas
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REFERENCES 1062. Runciman WB, Molle
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REFERENCES 1138. Chen YC, Chiang LC
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