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Overcoming Patient Barriers to Discussing Physician Hand Hygiene: Do Patients Prefer Electronic Reminders to Other Methods?

Published online by Cambridge University Press:  02 January 2015

Kaarin Michaelsen ,
Jason L. Sanders ,
Shanta M. Zimmer  and
Gregory M. Bump
Kaarin Michaelsen*
Affiliation:
University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Jason L. Sanders
Affiliation:
University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Shanta M. Zimmer
Affiliation:
University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania Department of Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
Gregory M. Bump
Affiliation:
University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania Department of Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
*
University of Pittsburgh School of Medicine, 200 Lothrop Street, Pittsburgh, PA 15213 ([email protected])
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Abstract

Background.

Despite agreement that handwashing decreases hospital-acquired infections (HAIs), physician hand hygiene remains suboptimal. Interventions to empower patients to discuss handwashing have had variable success.

Objective.

To understand patient perceived barriers to discussing physician hand hygiene and to determine whether patients prefer electronic alerts over printed information as an intervention to discuss physician handwashing.

Design.

Cross-sectional study of 250 medical/surgical patients at an academic medical center.

Results.

Ninety-six percent of patients had heard of HAIs. Ninety-six percent of patients thought it was important for physicians to clean their hands before touching anything in a patient's room. The majority of patients (78%) believed patients should remind physicians to clean their hands. Thirty-two percent of patients observed physician hand hygiene noncompliance. In multivariate analysis, predictors of not speaking up regarding physician hand hygiene included never having worked in health care (odds ratio [OR], 2.8 [95% confidence interval (CI), 1.5-5.1]), not observing a physician clean hands before touching the patient (OR, 2.4 [95% CI, 1.3-4.4]), and not thinking patients should have to remind physicians to clean hands (OR, 5.5 [95% CI, 2.4-12.7]). Ninety-three percent of patients favored electronic device reminders over printed information as an intervention to encourage patients to discuss hand hygiene with their doctors.

Conclusions.

The strongest predictor of not challenging a doctor to clean their hands was not believing it was the patient's role to do so. Patients prefer electronic device reminders to printed information as an aid in overcoming barriers to discussing hand hygiene with physicians.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 34 , Issue 9 , September 2013 , pp. 929 - 934
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

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References

1.Pittet, D, Boyce, JM. Hand hygiene and patient care: pursuing the Semmelweis legacy. Lancet Infect Dis 2001;1(suppl 1):9–20.CrossRefGoogle Scholar
2.Quaraishi, Z, McGuckin, M, Biais, F. Duration of handwashing frequency in intensive care units: a descriptive study. Am J Infect Control 1984;12(2):83–87.Google Scholar
3.Pittet, D, Mourouga, P, Perneger, TV. Compliance with handwashing in a teaching hospital. Ann Intern Med 1999;130(2):126–130.CrossRefGoogle ScholarPubMed
4.Pittet, D, Simon, A, Hugonnet, S, Pessoa-Silva, CL, Sauvan, V, Perneger, TV. Hand hygiene among physicians: performance, beliefs, and perceptions. Ann Intern Med 2004;141(l):1–8.Google Scholar
5.Conly, JM, Hill, S, Ross, J, Lertzman, J, Louie, TJ. Handwashing practices in an intensive care unit: the effects of an educational program and its relationship to infection rates. Am J Infect Control 1989;17(6):330–339.CrossRefGoogle Scholar
6.Pittet, D, Hugonnet, S, Harbarth, S, et al.Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet 2000;356(9238):1307–1312.Google Scholar
7.Larson, EL, Bryan, JL, Adler, LM, Blane, C. A multifaceted approach to changing handwashing behavior. Am J Infect Control 1997;25(1):3–10.CrossRefGoogle ScholarPubMed
8.Kaplan, LM, McGuckin, M. Increasing handwashing compliance with more accessible sinks. Infect Control 1986;7(8):408–410.Google Scholar
9.Bischoff, WE, Reynolds, TM, Sessler, CN, Edmond, MB, Wenzel, RRHandwashing compliance by health care workers: the impact of introducing an accessible, alcohol-based hand antiseptic. Arch Intern Med 2000;160(7):1017–1021.Google Scholar
10.Armellino, D, Hussain, E, Schilling, ME, et al.Using high-technology to enforce low-technology safety measures: the use of third-party remote video auditing and real-time feedback in healthcare. Clin Infect Dis 2012;54(1):1–7.CrossRefGoogle ScholarPubMed
11.McGuckin, M, Waterman, R, Porten, L, et al.Patient education model for increasing handwashing compliance. Am J Infect Control 1999;27(4):309–314.Google Scholar
12.McGuckin, M, Waterman, R, Storr, J, et al.Evaluation of a patient-empowering hand hygiene programme in the UK. J Hosp Infect 2001;48(3):222–227.CrossRefGoogle ScholarPubMed
13.McGuckin, M, Taylor, A, Martin, V, Porten, L, Salcido, R. Evaluation of a patient education model for increasing hand hygiene compliance in an in-patient rehabilitation unit. Am J Infect Control 2004;32(4):235–258.Google Scholar
14.Lent, V, Eckstein, E, Cameron, A, Budavich, R, Eckstein, B, Donskey, C. Evaluation of patient participation in a patient empowerment initiative to improve hand hygiene practices in a Veterans Affairs medical center. Am J Infect Control 2009;37(2):117–120.Google Scholar
15.McGuckin, M, Storr, J, Longtin, Y, Allegranzi, B, Pittet, D. Patient empowerment and multi-modal hand hygiene promotion: a win-win strategy. Am J Med Qual 2011;26(1):10–16.Google Scholar
16.Longtin, Y, Sax, H, Allegranzi, B, Hugonnet, S, Pittet, D. Patients' beliefs and perceptions of their participation to increase health care worker compliance with hand hygiene. Infect Control Hosp Epidemiol 2009;30(9):830–839.CrossRefGoogle ScholarPubMed
17.Waterman, A, Gallagher, T, Garbutt, J, Waterman, B, Fraser, V, Burroughs, T. Hospitalized patients' attitudes about and participation in error prevention. J Gen Intern Med 2006;21(4):367–370.CrossRefGoogle ScholarPubMed
18.Davis, RE, Koutantji, M, Vincent, CA. How willing are patients to question healthcare staff on issues related to the quality and safety of their healthcare? an exploratory study. Qual Saf Health Care 2008;17:90–96.Google Scholar
19.Duncanson, V, Pearson, LS. A study of the factors affecting the likelihood of patients participating in a campaign to improve staff hand hygiene. Br J Infect Control 2005;6(4):26–30.Google Scholar
20.Stewardson, A, Pittet, D. Quicker, easier, and cheaper? the promise of automated hand hygiene monitoring. Infect Control Hosp Epidemiol 2011;32(10):1029–1031.Google Scholar
21.Boyce, J. Measuring healthcare worker hand hygiene activity: current practices and emerging technologies. Infect Control Hosp Epidemiol 2011;32(10):1016–1018.Google Scholar
22.Edmond, MB, Goodell, A, Zuelzer, W, Sanogo, K, Elam, K, Bear-man, G. Successful use of alcohol sensor technology to monitor and report hand hygiene compliance. J Hosp Infect 2010;76(4):364–365.Google Scholar
23.Swoboda, SM, Earsing, K, Strauss, K, Lane, S, Lipsett, PA. Electronic monitoring and voice prompts improve hand hygiene and decrease nosocomial infections in an intermediate care unit. Crit Care Med 2004;32(2):358–363.Google Scholar