Why healthcare workers don't wash their hands: a behavioral explanation.

Abstract:

OBJECTIVE:To elucidate behavioral determinants of handwashing among nurses. DESIGN:Statistical modeling using the Theory of Planned Behavior and relevant components to handwashing behavior by nurses that were derived from focus-group discussions and literature review. SETTING:The community and 3 tertiary care hospitals. PARTICIPANTS:Children aged 9-10 years, mothers, and nurses. RESULTS:Responses from 754 nurses were analyzed using backward linear regression for handwashing intention. We reasoned that handwashing results in 2 distinct behavioral practices--inherent handwashing and elective handwashing--with our model explaining 64% and 76%, respectively, of the variance in behavioral intention. Translation of community handwashing behavior to healthcare settings is the predominant driver of all handwashing, both inherent (weighted beta =2.92) and elective (weighted beta =4.1). Intended elective in-hospital handwashing behavior is further significantly predicted by nurses' beliefs in the benefits of the activity (weighted beta =3.12), peer pressure of senior physicians (weighted beta =3.0) and administrators (weighted beta =2.2), and role modeling (weighted beta =3.0) but only to a minimal extent by reduction in effort (weighted beta =1.13). Inherent community behavior (weighted beta =2.92), attitudes (weighted beta =0.84), and peer behavior (weighted beta =1.08) were strongly predictive of inherent handwashing intent. CONCLUSIONS:A small increase in handwashing adherence may be seen after implementing the use of alcoholic hand rubs, to decrease the effort required to wash hands. However, the facilitation of compliance is not simply related to effort but is highly dependent on altering behavioral perceptions. Thus, introduction of hand rub alone without an associated behavioral modification program is unlikely to induce a sustained increase in hand hygiene compliance.

authors

Whitby M,McLaws ML,Ross MW

doi

10.1086/503335

subject

Has Abstract

pub_date

2006-05-01 00:00:00

pages

484-92

issue

5

eissn

0899-823X

issn

1559-6834

pii

ICHE2005051

journal_volume

27

pub_type

杂志文章
  • Four Moments for Patient Hand Hygiene: A Patient-Centered, Provider-Facilitated Model to Improve Patient Hand Hygiene.

    abstract::We found that a majority of hospitalized patients were aware of the importance of hand hygiene, but observations indicated that performance of hand hygiene was uncommon. An intervention in which healthcare personnel facilitated hand hygiene at specific moments significantly increased performance of hand hygiene by pat...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1017/ice.2015.78

    authors: Sunkesula VC,Knighton S,Zabarsky TF,Kundrapu S,Higgins PA,Donskey CJ

    更新日期:2015-08-01 00:00:00

  • An investigation of potential neurosurgical transmission of Creutzfeldt-Jakob disease: challenges and lessons learned.

    abstract::In 2001, New York State health officials were notified about 2 patients with Creutzfeldt-Jakob disease who had undergone neurosurgical procedures at the same hospital within 43 days of each other. One patient had Creutzfeldt-Jakob disease at the time of surgery; the other patient developed Creutzfeldt-Jakob disease 6....

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/503017

    authors: Stricof RL,Lillquist PP,Thomas N,Belay ED,Schonberger LB,Morse DL

    更新日期:2006-03-01 00:00:00

  • Implementation of a clinical decision support system for antimicrobial stewardship.

    abstract::Clinical decision support systems (CDSSs) for antimicrobial stewardship require considerable human resources and financial investments. This pre-/postimplementation study evaluated the effect of a CDSS on performance of prospective audit with intervention and feedback and demonstrated an increase in interventions and ...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/664762

    authors: Hermsen ED,VanSchooneveld TC,Sayles H,Rupp ME

    更新日期:2012-04-01 00:00:00

  • Risk factors for fecal colonization with multiple distinct strains of Escherichia coli among long-term care facility residents.

    abstract::Of 49 long-term care facility residents, 21 (43%) were colonized with 2 or more distinct strains of Escherichia coli. There were no significant risk factors for colonization with multiple strains of E. coli. These results suggest that future efforts to efficiently identify the diversity of colonizing strains will be c...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/597234

    authors: Lautenbach E,Tolomeo P,Black N,Maslow JN

    更新日期:2009-05-01 00:00:00

  • A large outbreak of Clostridium difficile-associated disease with an unexpected proportion of deaths and colectomies at a teaching hospital following increased fluoroquinolone use.

    abstract:BACKGROUND AND OBJECTIVE:Fluoroquinolones have not been frequently implicated as a cause of Clostridium difficile outbreaks. Nosocomial C. difficile infections increased from 2.7 to 6.8 cases per 1000 discharges (P < .001). During the first 2 years of the outbreak, there were 253 nosocomial C. difficile infections; of ...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/502539

    authors: Muto CA,Pokrywka M,Shutt K,Mendelsohn AB,Nouri K,Posey K,Roberts T,Croyle K,Krystofiak S,Patel-Brown S,Pasculle AW,Paterson DL,Saul M,Harrison LH

    更新日期:2005-03-01 00:00:00

  • Appropriateness of antibiotic prophylaxis for major surgery in Korea.

    abstract:OBJECTIVE:To determine the appropriateness of antibiotic prophylaxis regimens for major surgery in Korea. DESIGN:Retrospective study using a written survey for each patient who underwent arthroplasty, colon surgery, or hysterectomy. SETTING:Six tertiary hospitals in Seoul and Gyeonggi Province. PATIENTS:From each ho...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/519180

    authors: Choi WS,Song JY,Hwang JH,Kim NS,Cheong HJ

    更新日期:2007-08-01 00:00:00

  • Investigations of intrinsic Pseudomonas cepacia contamination in commercially manufactured povidone-iodine.

    abstract:OBJECTIVE:Laboratory investigations were initiated with a povidone-iodine antiseptic solution that was intrinsically contaminated with Pseudomonas cepacia. These investigations were helpful in understanding the microbicidal and chemical properties of iodophor solutions and the mechanism by which P cepacia can survive i...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/646342

    authors: Anderson RL,Vess RW,Carr JH,Bond WW,Panlilio AL,Favero MS

    更新日期:1991-05-01 00:00:00

  • Selective surveillance for nosocomial infections in a Brazilian hospital.

    abstract:OBJECTIVE:To devise a system for surveying the frequency of nosocomial infections in a tertiary care hospital in a developing country. DESIGN:Prospective selective surveillance by nurses of the charts of patients at high risk for nosocomial infections, as identified by a form completed by resident physicians. The sens...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/646715

    authors: Lima NL,Pereira CR,Souza IC,Facanha MC,Lima AA,Guerrant RL,Farr BM

    更新日期:1993-04-01 00:00:00

  • Current infection prevention and antibiotic stewardship program practices: A survey of the Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN).

    abstract::We used a survey to characterize contemporary infection prevention and antibiotic stewardship program practices across 64 healthcare facilities, and we compared these findings to those of a similar 2013 survey. Notable findings include decreased frequency of active surveillance for methicillin-resistant Staphylococcus...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章,多中心研究

    doi:10.1017/ice.2019.172

    authors: Chiotos K,Rock C,Schweizer ML,Deloney VM,Morgan DJ,Milstone AM,Henderson DK,Harris AD,Han JH

    更新日期:2019-09-01 00:00:00

  • Precautionary practices of healthcare workers who disinfect medical and dental devices using high-level disinfectants.

    abstract::BACKGROUND High-level disinfectants (HLDs) are used throughout the healthcare industry to chemically disinfect reusable, semicritical medical and dental devices to control and prevent healthcare-associated infections among patient populations. Workers who use HLDs are at risk of exposure to these chemicals, some of wh...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1017/ice.2014.37

    authors: Henn SA,Boiano JM,Steege AL

    更新日期:2015-02-01 00:00:00

  • Nosocomial methicillin-resistant Staphylococcus aureus bacteremia: is it any worse than nosocomial methicillin-sensitive Staphylococcus aureus bacteremia?

    abstract:OBJECTIVE:To determine the comparative virulence of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive S aureus (MSSA) by consideration of predisposing factors and outcomes in patients infected with these organisms in the healthcare setting. DESIGN:Analysis of an historical cohort of 504 bact...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/501707

    authors: Selvey LA,Whitby M,Johnson B

    更新日期:2000-10-01 00:00:00

  • Long-term outcomes of an antimicrobial stewardship program implemented in a hospital with low baseline antibiotic use.

    abstract:OBJECTIVE:To evaluate the long-term outcomes of an antimicrobial stewardship program (ASP) implemented in a hospital with low baseline antibiotic use. DESIGN:Quasi-experimental, interrupted time-series study. SETTING:Public safety net hospital with 525 beds. INTERVENTION:Implementation of a formal ASP in July 2008. ...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1017/ice.2015.41

    authors: Jenkins TC,Knepper BC,Shihadeh K,Haas MK,Sabel AL,Steele AW,Wilson ML,Price CS,Burman WJ,Mehler PS

    更新日期:2015-06-01 00:00:00

  • Epidemiologic study of nosocomial urinary tract infections in Saudi military hospitals.

    abstract::A case-control study of patients with and without confirmed UTI was performed to identify risk factors for nosocomial UTI. Duration of hospitalization, unit of admission, history of diabetes mellitus or debilitating diseases, and duration and number of urinary catheters were independently associated with increased ris...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/502336

    authors: Al-Helali NS,Al-Asmary SM,Abdel-Fattah MM,Al-Jabban TM,Al-Bamri AL

    更新日期:2004-11-01 00:00:00

  • A neonatal specialist with recurrent methicillin-resistant Staphylococcus aureus (MRSA) carriage implicated in the transmission of MRSA to newborns.

    abstract::This study reports an investigation of outbreaks of methicillin-resistant Staphylococcus aureus (MRSA) infection and colonization involving 17 newborns in the neonatal unit of a teaching hospital. A neonatal specialist colonized with MRSA that eventually became mupirocin-resistant was implicated as a recurrent source ...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/513616

    authors: Méan M,Mallaret MR,Andrini P,Recule C,Debillon T,Pavese P,Croizé J

    更新日期:2007-05-01 00:00:00

  • Optimizing utilization of beta-lactam surgical prophylaxis through implementation of a structured allergy assessment tool in a presurgical clinic.

    abstract::In patients with β-lactam allergies, administration of non-β-lactam surgical prophylaxis is associated with increased risk of infection. Although many patients self-report β-lactam allergies, most are unconfirmed or mislabeled. A quality improvement process, utilizing a structured β-lactam allergy tool, was implemente...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1017/ice.2019.274

    authors: Margallo JP,Smith EA,Marks G,Ben-Aderet M,Yang H,Madhusudhan M,Krishna S,Duran A,Friedman A,Cassel SL,Tran H,Shane R,Murthy RK,Grein JD

    更新日期:2019-12-01 00:00:00

  • Cost-effectiveness of hepatitis A vaccination in healthcare workers.

    abstract:OBJECTIVE:To study the cost-effectiveness of vaccination for hepatitis A. SETTING:Hypothetical analysis of students currently enrolled in medical school in the United States. METHOD:A Markov-based model was developed using data from the literature, actual hospital costs, and an annual discount rate of 5%. The inciden...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/647513

    authors: Smith S,Weber S,Wiblin T,Nettleman M

    更新日期:1997-10-01 00:00:00

  • The impact of changing reflexive to clinician-ordered Clostridioides difficile polymerase chain reaction (PCR) testing for indeterminate cases: Cost savings without associated adverse events.

    abstract:OBJECTIVE:To evaluate changing Clostridioides difficile infection (CDI) testing among inpatients with indeterminate enzyme immunoassay (EIA) results (antigen+/toxin-) from reflexive polymerase chain reaction (PCR) testing to clinician-ordered PCR testing. DESIGN:Multicenter, before-and-after, quasi-experimental study....

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1017/ice.2020.56

    authors: Sullivan EL,Majumdar R,Ortiz C,Riggs PK,Crum-Cianflone NF

    更新日期:2020-06-01 00:00:00

  • Prevention of central venous catheter-related bloodstream infections using non-technologic strategies.

    abstract:OBJECTIVE:To evaluate the incidence of nosocomial bacteremias related to the use of non-impregnated central venous catheters (CVCs) when only non-technologic strategies were used to prevent them. DESIGN:This was a prospective study of infectious complications of CVCs placed in intensive care unit (ICU) patients from A...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/502461

    authors: Gnass SA,Barboza L,Bilicich D,Angeloro P,Treiyer W,Grenóvero S,Basualdo J

    更新日期:2004-08-01 00:00:00

  • Quantifying the Exposure to Antibiotic-Resistant Pathogens Among Patients Discharged From a Single Hospital Across All California Healthcare Facilities.

    abstract:OBJECTIVE:To assess the time-dependent exposure of California healthcare facilities to patients harboring methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae, and Clostridium difficile infec...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1017/ice.2015.181

    authors: Datta R,Brown S,Nguyen VQ,Cao C,Billimek J,Avery T,Lee BY,Huang SS

    更新日期:2015-11-01 00:00:00

  • Emergency Department Catheter-Associated Urinary Tract Infection Prevention: Multisite Qualitative Study of Perceived Risks and Implemented Strategies.

    abstract:BACKGROUND:Existing knowledge of emergency department (ED) catheter-associated urinary tract infection (CAUTI) prevention is limited. We aimed to describe the motivations, perceived risks for CAUTI acquisition, and strategies used to address CAUTI risk among EDs that had existing CAUTI prevention programs. METHODS:In ...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1017/ice.2015.267

    authors: Carter EJ,Pallin DJ,Mandel L,Sinnette C,Schuur JD

    更新日期:2016-02-01 00:00:00

  • Optimal frequency of changing intravenous administration sets: is it safe to prolong use beyond 72 hours?

    abstract:OBJECTIVE:To determine the safety and cost-effectiveness of replacing the intravenous (IV) tubing sets in hospitalized patients at 4- to 7-day intervals instead of every 72 hours. DESIGN:Prospective, randomized study of infusion-related contamination associated with changing IV tubing sets within 3 days versus within ...

    journal_title:Infection control and hospital epidemiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1086/501879

    authors: Raad I,Hanna HA,Awad A,Alrahwan A,Bivins C,Khan A,Richardson D,Umphrey JL,Whimbey E,Mansour G

    更新日期:2001-03-01 00:00:00

  • Prevalence and risk factors associated with vancomycin-resistant Staphylococcus aureus precursor organism colonization among patients with chronic lower-extremity wounds in Southeastern Michigan.

    abstract:BACKGROUND:Of the 13 US vancomycin-resistant Staphylococcus aureus (VRSA) cases, 8 were identified in southeastern Michigan, primarily in patients with chronic lower-extremity wounds. VRSA infections develop when the vanA gene from vancomycin-resistant enterococcus (VRE) transfers to S. aureus. Inc18-like plasmids in V...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/671735

    authors: Tosh PK,Agolory S,Strong BL,Verlee K,Finks J,Hayakawa K,Chopra T,Kaye KS,Gilpin N,Carpenter CF,Haque NZ,Lamarato LE,Zervos MJ,Albrecht VS,McAllister SK,Limbago B,Maccannell DR,McDougal LK,Kallen AJ,Guh AY

    更新日期:2013-09-01 00:00:00

  • Emerging infectious diseases in the institutional setting: another hot zone.

    abstract::During the closing years of the 20th century, there has been an unprecedented number of newly recognized infectious agents and a resurgence of infectious diseases only recently thought to be conquered. These problems have been compounded by the increasing number of pathogens that have evolved resistance to antimicrobi...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章,评审

    doi:10.1086/647347

    authors: Ostroff SM

    更新日期:1996-08-01 00:00:00

  • Peripheral venous catheter-related Staphylococcus aureus bacteremia.

    abstract:OBJECTIVE:Better understand the incidence, risk factors, and outcomes of peripheral venous catheter (PVC)-related Staphylococcus aureus bacteremia. DESIGN:Retrospective study of PVC-related S. aureus bacteremias in adult patients from July 2005 through March 2008. A point-prevalence survey was performed January 9, 200...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/660099

    authors: Trinh TT,Chan PA,Edwards O,Hollenbeck B,Huang B,Burdick N,Jefferson JA,Mermel LA

    更新日期:2011-06-01 00:00:00

  • Monitoring persistence of coagulase-negative staphylococci in a hematology department using phenotypic and genotypic strategies.

    abstract:OBJECTIVE:To determine persistence of coagulase-negative staphylococci (CNS) on a hematology-oncology ward and to determine the value of phenotypic and genotypic procedures for establishing clonality among CNS isolates. DESIGN:Strains of CNS isolated from bacteremic patients (n = 139) were typed by biochemical reactiv...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:

    authors: van Belkum A,Kluijtmans J,van Leeuwen W,Goessens W,ter Averst E,Wielenga J,Verbrugh H

    更新日期:1996-10-01 00:00:00

  • Evaluation of Staphylococcus aureus Bacteremia: Academic and Community-Based Management Within the Same Health System.

    abstract::A nonrandomized, retrospective comparison of Staphylococcus aureus bacteremia between an academic hospital setting (n=53) and a community hospital setting (n=245) within a single healthcare system was performed. Despite infectious disease consultations, S. aureus bacteremia management recommendations based on Infectio...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1017/ice.2017.30

    authors: Ased S,Rayes H,Dhami J,Amosson N,Fordjour A,Macaraeg J,Vivekanandan R,Wilson J,Cabri A,Davids M,Anthone J,Cavalieri S,Destache CJ

    更新日期:2017-06-01 00:00:00

  • Intravascular catheter colonization in critically ill children.

    abstract::In a prospective study, cultures were obtained of all intravascular catheters removed from children in an intensive care unit. Of 366 catheters removed from 217 children, 110 (30%) were found to be colonized, most commonly with coagulase-negative staphylococci. Despite the high rate of colonization, there were only ni...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/647625

    authors: Schlager TA,Hidde M,Rodger P,Germanson TP,Donowitz LG

    更新日期:1997-05-01 00:00:00

  • Clinical and epidemiologic features of methicillin-resistant Staphylococcus aureus in elderly hospitalized patients.

    abstract::We describe characteristics of elderly patients with MRSA identified in 37 Canadian hospitals between 1995 and 2002. Of these inpatients, 6,613 (66%) were older than 65 years. They were more likely than younger patients to have been colonized without infection and to have had MRSA isolated from urine or the perineum. ...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章,多中心研究

    doi:10.1086/502503

    authors: Simor AE,Ofner-Agostini M,Paton S,McGeer A,Loeb M,Bryce E,Mulvey M,Canadian Nosocomial Infection Surveillance Program.

    更新日期:2005-10-01 00:00:00

  • Annual tuberculin skin testing of employees at a university hospital: a cost-benefit analysis.

    abstract::The usefulness of routine annual tuberculin skin testing (purified protein derivative [PPD]) of hospital employees has been questioned. Between 1984 and the end of 1987 the PPD conversion rates of hospital employees at a university and psychiatric hospital in North Florida were compared. The number of employees in bot...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/645922

    authors: Raad I,Cusick J,Sherertz RJ,Sabbagh M,Howell N

    更新日期:1989-10-01 00:00:00

  • Controlling use of antimicrobials in a community teaching hospital.

    abstract:OBJECTIVE:To test the hypothesis that antibiotic use could be controlled or improved in a community teaching hospital, with improvement defined as reductions in overall use, overall cost, and antimicrobial resistance. DESIGN:Interventional study with historical comparison. SETTING:A not-for-profit, 900-bed community ...

    journal_title:Infection control and hospital epidemiology

    pub_type: 杂志文章

    doi:10.1086/500419

    authors: Philmon C,Smith T,Williamson S,Goodman E

    更新日期:2006-03-01 00:00:00