A qualitative study of hand hygiene compliance among health care workers in intensive care units

  • Pinar Ay Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey
  • Ayse Gulsen Teker Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey
  • Seyhan Hidiroglu Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey
  • Pinar Tepe Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey
  • Aysen Surmen Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey
  • Uluhan Sili Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey
  • Volkan Korten Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey
  • Melda Karavus Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey
Keywords: Hand hygiene compliance, qualitative study, healthcare-associated infections, intensive care unit

Abstract

Introduction: Studies indicate that adherence to hand hygiene guidelines is at suboptimal levels. We aimed to explore the reasons for poor hand hygiene compliance.

Methodology: A qualitative study based on the Theory of Planned Behavior as a framework in explaining compliance, consisting four focus group discussions and six in-depth interviews.

Results: Participants mostly practiced hand hygiene depending on the sense of "dirtiness" and "cleanliness". Some of the participants indicated that on-job training delivered by the infection control team changed their perception of "emotionally" based hand hygiene to "indication" based. Direct observations and individual feedback on one-to-one basis were the core of this training. There was low social cohesiveness and a deep polarization between the professional groups that led one group accusing the other for not being compliant.

Conclusions: The infection control team should continue delivering one-to-one trainings based on observation and immediate feedback. But there is need to base this training model on a structured behavioral modification program and test its efficacy through a quasi-experimental design. Increasing social cohesiveness and transforming the blaming culture to a collaborative safety culture is also crucial to improve compliance. High workload, problems related to work-flow and turnover should be addressed.

Published
2019-02-28
How to Cite
1.
Ay P, Teker A, Hidiroglu S, Tepe P, Surmen A, Sili U, Korten V, Karavus M (2019) A qualitative study of hand hygiene compliance among health care workers in intensive care units. J Infect Dev Ctries 13:111-117. doi: https://doi.org/10.3855/jidc.10926
Section
Original Articles