Researchers Study Behavioral Theory Approach to Understand Barriers to Physician Hand Hygiene

Healthcare-associated infections affect 10 percent of patients in Canadian acute-care hospitals and are significant and preventable causes of morbidity and mortality among hospitalized patients. Hand hygiene is among the simplest and most effective preventive measures to reduce these infections. However, compliance with hand hygiene among healthcare workers, specifically among physicians, is consistently suboptimal. In an upcoming study, Squires, et al. (2013) aim to first identify the barriers and enablers to physician hand hygiene compliance, and then to develop and pilot a theory-based knowledge translation intervention to increase physicians compliance with best hand hygiene practice.

The study consists of three phases. In Phase 1, the researchers will identify barriers and enablers to hand hygiene compliance by physicians. This will include: key informant interviews with physicians and residents using a structured interview guide, informed by the Theoretical Domains Framework; nonparticipant observation of physician/resident hand hygiene audit sessions; and focus groups with hand hygiene experts. In Phase 2, the researchers will conduct intervention mapping to develop a theory-based knowledge translation intervention to improve physician hand hygiene compliance. Finally, in Phase 3, they will pilot the knowledge translation intervention in four patient-care units.

In this study, the researchers say they will use a behavioral theory approach to obtain a better understanding of the barriers and enablers to physician hand hygiene compliance. This will provide a comprehensive framework on which to develop knowledge translation interventions that may be more successful in improving hand hygiene practice. Upon completion of this study, the researchers will refine the piloted knowledge translation intervention so it can be tested in a multi-site cluster randomized controlled trial.

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Reference: Squires JE, Suh KN, et al.  Improving physician hand hygiene compliance using behavioural theories: a study protocol. Implementation Science 2013, 8:16 doi:10.1186/1748-5908-8-16