Understanding the determinants of Australian hospital nurses' hand hygiene decisions following the implementation of a national hand hygiene initiative

Katherine M White; Louise C Starfelt; Nerina L Jimmieson; Megan Campbell; Nicholas Graves; Adrian G Barnett; Wendell Cockshaw; Phillip Gee; Katie Page; Elizabeth Martin; David Brain; David Paterson

doi:10.1093/her/cyv057

Understanding the determinants of Australian hospital nurses' hand hygiene decisions following the implementation of a national hand hygiene initiative

Health Educ Res. 2015 Dec;30(6):959-70. doi: 10.1093/her/cyv057.

Authors

Affiliations

¹ School of Psychology and Counselling, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane 4059, Australia, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane 4059, Australia, km.white@qut.edu.au.
² School of Psychology and Counselling, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane 4059, Australia.
³ School of Management, Queensland University of Technology, 2 George Street, Brisbane 4000, Australia.
⁴ Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane 4059, Australia.
⁵ School of Psychology and Counselling, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane 4059, Australia, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane 4059, Australia.
⁶ School of Psychology, The University of Queensland, Sir Fred Schonell Drive, St Lucia, Brisbane, 4072, Australia.
⁷ The University of Queensland Centre for Clinical Research, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Brisbane 4029, Australia.

PMID: 26590244
DOI: 10.1093/her/cyv057

Abstract

Hand hygiene is the primary measure in hospitals to reduce the spread of infections, with nurses experiencing the greatest frequency of patient contact. The '5 critical moments' of hand hygiene initiative has been implemented in hospitals across Australia, accompanied by awareness-raising, staff training and auditing. The aim of this study was to understand the determinants of nurses' hand hygiene decisions, using an extension of a common health decision-making model, the theory of planned behaviour (TPB), to inform future health education strategies to increase compliance. Nurses from 50 Australian hospitals (n = 2378) completed standard TPB measures (attitude, subjective norm, perceived behavioural control [PBC], intention) and the extended variables of group norm, risk perceptions (susceptibility, severity) and knowledge (subjective, objective) at Time 1, while a sub-sample (n = 797) reported their hand hygiene behaviour 2 weeks later. Regression analyses identified subjective norm, PBC, group norm, subjective knowledge and risk susceptibility as the significant predictors of nurses' hand hygiene intentions, with intention and PBC predicting their compliance behaviour. Rather than targeting attitudes which are already very favourable among nurses, health education strategies should focus on normative influences and perceptions of control and risk in efforts to encourage hand hygiene adherence.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Aged
Australia
Decision Making*
Decision Support Techniques
Female
Hand Hygiene*
Health Knowledge, Attitudes, Practice*
Humans
Inservice Training
Intention
Male
Middle Aged
Nursing Staff, Hospital / psychology*
Perception
Risk Assessment
Young Adult