Investigators Explore Hand Hygiene Etymology

Kilpatrick and Storr (2017) assert that numerous studies have focused on healthcare workers’ perceptions of hand hygiene but few have addressed the etymology of hand hygiene and its influence. As they explain, "Words influence behavior. The increasing use of social marketing in infection prevention is testament to the value of words in campaigning for change. However, an exploration of the use of words related to hand hygiene improvement and the World Health Organization (WHO)'s recommendations has until now received scant attention. Compliance with hand hygiene remains sub-optimal across the globe and novel approaches for behavioral impact have the potential to offer valuable adjuncts to current strategies.

The researchers sought to describe the feelings evoked by five words commonly used in a hand hygiene context. An exploratory exercise assessed the feelings evoked by five words commonly used in a hand hygiene context. A classic psychology experiment was used to evoke an instant, emotional reaction. From June 2013 to May 2014, a total of 23 face to face exercises were undertaken in seven different countries. This convenience sample totaled 2,100 people consisting of nurses, doctors, senior management and a diverse range of other health workers and managers. The words tested were alcohol based handrub, compliance, monitoring, moment and system. Qualitative analysis of the findings was undertaken.

Responses i.e., the words captured, were categorized as “warm” and “cold.” During the exercises 240 words representing alcohol based handrub were collected, 510 representing compliance, 402 representing monitoring, 480 representing moment and 200 representing system. Compliance in particular evoked negative feelings, with ‘cold words’ being described on hearing this word. The word moment evoked the most positive reactions (‘warm words’).

The researchers conclude, "WHO guidelines state that clear and uniform language in hand hygiene matters. Social marketing falls into the fourth component of
the WHO multimodal strategy, described as 'reminders in the workplace.' This novel exercise has potential to stimulate the infection prevention (and academic) community to revisit the words it uses within policies/guidelines and day-to-day communications in their quest to bring about the socially desired change [hand hygiene at the right time] as a part of a multimodal approach.

Disclosure: Claire Kilpatrick and Jules Storr are consultants for GOJO Industries.

Reference: Kilpatrick C and Storr J. How we talk about hand hygiene matters – an exploration of hand hygiene etymology. Antimicrobial Resistance and Infection Control 2017, 6(Suppl 3):I10