9.4.2 Factors that contribute to healthcare workers non-compliance with hand hygiene guidelines: A multicenter observational study in Ireland (67)

Sile Creedon, College Lecturer, School of Nursing and Midwifery, University College Cork, Cork, Ireland Co authors: Mai Mannix

Abstract:

The primary purpose of this research was to investigate healthcare workers compliance with hand hygiene guidelines in four acute care settings (Centers 1 to 4) and contributory factors to non-compliance. Data (n=1737 observations) were drawn from a random sample of nurses, doctors, physiotherapists and care assistants (n=208 observational subjects). Descriptive analysis revealed compliance rates of 51% upwards for specific guidelines. In order to investigate contributory factors to non-compliance (independent variable) discipline, area (ward type), gender and center were used as dependant variables. A previously validated observational schedule (Creedon, 2005) was used. Inter-rater reliability (two observers) was established at 0.88. Univariate logistic regression analysis revealed trends previously confirmed. Gender, discipline and area had a statistically significant (all p < .05) impact on healthcare workers non-compliance. A key finding using multivariate logistic regression analysis revealed that Center 4 had a significantly higher likelihood of non-compliance than all other centers (p=0.003). Therefore, it appears that the single most important contributory factor towards healthcare workers non-compliance with hand hygiene guidelines was the center they worked in. Findings from this study make an important contribution to the body of knowledge underpinning healthcare workers hand hygiene behaviour. The single most important contributory factor towards healthcare workers non-compliance with hand hygiene guidelines was the center they worked in. A possible explanation may be related to organizational behaviour and hospital culture as each center was equitably funded (public) and staffed. No literature exists on the association between organizational behaviour and hospital culture in relation to healthcare workers hand hygiene practices.. In light of findings from this study, healthcare workers perceptions of organizational behaviour and culture should be considered when investigating non-compliance with hand hygiene guidelines and subsequent design of interventional programs.

Reference:

Creedon, S. (2005). Healthcare workers compliance with hand hygiene guidelines. Journal of Advanced Nursing. 51 (3), 208-216

Biography:

Sile A Creedon is a lecturer in University College Cork and has many publications in the area of healthcare workers hand hygiene behaviour. She is currently studying for her Phd with City University London. Her background is in Nursing and Midwifery and she has been employed in nurse education since 1996. Her main research interests to date have been in the area of infection control in acute care settings. Dr. Mai Mannix is a specialist in Public Health Medicine and works with the Department of Public Health, Health Service Executive Ireland. Dr Mannix has a number of resesarch interests including infection control, durg / alcohol use and provision of diabetes services.