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

Journal article


White, Katherine M., Starfelt, Louise C., Jimmieson, Nerina L., Campbell, Megan, Graves, Nicholas, Barnett, Adrian G., Cockshaw, Wendell, Gee, Phillip, Page, Katie, Martin, Elizabeth, Brain, David and Paterson, David. (2015). Understanding the determinants of Australian hospital nurses' hand hygiene decisions following the implementation of a national hand hygiene initiative. Health Education Research. 30(6), pp. 959 - 970. https://doi.org/10.1093/her/cyv057
AuthorsWhite, Katherine M., Starfelt, Louise C., Jimmieson, Nerina L., Campbell, Megan, Graves, Nicholas, Barnett, Adrian G., Cockshaw, Wendell, Gee, Phillip, Page, Katie, Martin, Elizabeth, Brain, David and Paterson, David
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.

Keywordsnurses; perception; behavior; washing hands
Year2015
JournalHealth Education Research
Journal citation30 (6), pp. 959 - 970
PublisherOxford University Press
ISSN0268-1153
Digital Object Identifier (DOI)https://doi.org/10.1093/her/cyv057
Scopus EID2-s2.0-84958676478
Page range959 - 970
Publisher's version
File Access Level
Controlled
Place of publicationUnited Kingdom
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