A new interactive approch to improve hand hygiene compliance

Abstract number: 1134_02_323

Holt J., Tvenstrup Jensen E., Buhl D.

Introduction:

The compliance of guidelines for hand hygiene is well below 50 % despite several at-tempts to improve. When planning an educational outline to promote a behavioural change in the hand hygiene practice in the aim of lowering the incidence of Nosoco-mial Infections the mapping of critical factors and implications that affect this practice is of utmost importance.

Objectives:

This study was an empirical investigation of the aspects of the hand hygienic practice as it takes place in the Danish health care system today. The study attempted to answer the question:''How can the health staff's lack of compliance with hand hygiene be explained and understood as basis for planning an educational material to support a behavioural change.''

Methods:

Literature studies of hand hygiene, a questionnaire based done survey (1700 per-sons/294 respondents) and qualitative interviews (N = 15) was performed in order to uncover the explanations for this low rate of compliance.The data was analysed and discussed on the basis of theories on action, experience, reflective thinking, control and rituals in order to aim for a broader view and under-standing of this field.

Results:

Both the questionnaire and interviews showed that hygiene still is a field that has great implications on the interactions between individuals. Furthermore it seemed dif-ficult for the staff to draw a professional and not a private line between ''the clean and the unclean'' and thereby perform hand hygiene without compromising each other. Further the interviews showed that it is difficult for the staff to react on something they cannot see and that not gives an immediate result when staff does not act as pre-scribed.

Conclusions:

Hand hygiene training should be targeted using a new approach which puts focus on the interpersonal relations and who allows interactivity to build up experience with what happens when you do not perform hand hygiene. The training should aim for an open minded dialogue and should be taught in a media that allows reflection, experi-mental learning and shows the invisible. On the basis of this study a web based train-ing program in hand hygiene who allows staff and all others with interest in this field has been developed and is now available in Danish on the Statens Serum Institut web-site (www.ssi.dk). The training program contains facts on hand hygiene, latest litera-ture and gives room for visualising, experiments and testing.