Exploring determinants of hand hygiene among hospital nurses: a qualitative study
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RESEARCH ARTICLE
Open Access
Exploring determinants of hand hygiene among hospital nurses: a qualitative study Mohtasham Ghaffari1, Sakineh Rakhshanderou1, Ali Safari-Moradabadi2 and Hassan Barkati3*
Abstract Background: The present research is a qualitative one aiming to determine factors affecting hand-hygiene behavior of the nursing staff in Shariati Hospital of Tehran, Iran. Methods: This was a qualitative study performed using content analysis approach. Considering the aim of the study, 16 in-depth semi-structured interviews were held with the nursing staff of Shariati Hospital of Tehran University of Medical Sciences. A convenient sampling was performed and continued until data saturation and until no new codes and categories were obtained. Data were analyzed through a qualitative content analysis based on the Graham and landsman method. Directed qualitative content analysis was done in order to analyze the data. Results: The results of this study revealed 3 main themes in the Theory of Planned Behavior (TPB) (attitude, subjective norms and perceived behavioral control) and 8 main themes in the outside the framework (environment, perceptions, life style, morality, education, organizational culture, salience and personality). Conclusion: Due to the other factors also found in this study, an integration of theories and models for designing of interventions is recommended to increase adherence to hand hygiene behavior. Keywords: Hand hygiene, Hand washing, Theory of planned behavior, Nursing
Background Hand Hygiene [HH] is a simple way to reduce hospital infections, to prevent the spread of antimicrobial resistance and to increase patients’ security [1]. A mere hand washes stands as a primary way of preventing the spread of hospital infections. A hand wash would cut down on 50% of hospital infections [2]. Hospital infections lengthen patients’ stay in hospital, impose high costs on patients and the health system of the whole country. They may also cause mortalities [3]. According to the results of a review study, Compliance with HH Guidelines were lower in intensive care units (30–40%) than in general ward (50–60%), lower among physicians (32%) than among nurses (48%), and before (21%) rather than after (47%) patient contact. Also, compliance rates higher * Correspondence: [email protected] 3 Health Education and Health Promotion, Social Deputy, Tehran University of Medical Sciences, Tehran, Iran Full list of author information is available at the end of the article
than 50% were found among 41% of samples of nurses, 20% of physicians, 47% of other health care worker(s), and 25% of health care worker(s) of unreported profession [3]. Although the rising trend of HH protocols is indicative of the lower occurrence of infection, still taking HH serious among other specialized teams has remained poor [4]. According to the figures reported by WHO, 1, 400,000 people worldwide suffer from the side effects of hospital infections, per second. In developing countries, the rate of preventable infections induced
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