Importance of Education to Hand Hygiene Compliance
Concepts such as social marketing and positive deviance as related to hand hygiene compliance rely in some part on education and training efforts. Sometimes, understanding what healthcare workers know and like – and what they do not – is the first step toward improved education. Wisniewski et al. (2007) sought to evaluate infection control and hand hygiene understanding at three hospitals by surveying 4,345 healthcare workers three times during a five-year infection control intervention. The researchers found, for example, that all kinds of healthcare professionals preferred to use alcohol-based handrub, that interactive education sessions improved attendance of in-services, and that both of these factors influenced hand hygiene behavior.
Erasmus et al. (2009) sought to study potential determinants of hand hygiene compliance among healthcare workers in the hospital setting. The study was based on responses to structured interviews conducted in nine focus groups involving 65 nurses, attending physicians, medical residents, and medical students working in the intensive care units and surgical departments of five hospitals in the Netherlands. Erasmus et al. (2009) report, “Nurses and medical students expressed the importance of hand hygiene for preventing of cross-infection among patients and themselves. Physicians expressed the importance of hand hygiene for self-protection, but they perceived that there is a lack of evidence that handwashing is effective in preventing cross-infection. All participants stated that personal beliefs about the efficacy of hand hygiene and examples and norms provided by senior hospital staff are of major importance for hand hygiene compliance. They further reported that hand hygiene is most often performed after tasks that they perceive to be dirty, and personal protection appeared to be more important for compliance that patient safety. Medical students explicitly mentioned that they copy the behavior of their superiors, which often leads to noncompliance during clinical practice. Physicians mentioned that their noncompliance arises from their belief that the evidence supporting the effectiveness of hand hygiene for prevention of hospital-acquired infections is not strong. The results indicate that beliefs about the importance of self-protection are the main reasons for performing hand hygiene. A lack of positive role models and social norms may hinder compliance.”
