Impact of observing hand hygiene in practice and research: a methodological reconsideration

Journal of Hospital Infection

Volumn 95, Issue 2, 2017, Pages 169-174

  Gould, D J ^a   Creedon, S ^b   Jeanes, A ^c   Drey, N S ^d   Chudleigh, J ^e   Moralejo, D ^f  

^a CARDIFF UNIVERSITY   (United Kingdom)

^b UNIVERSITY COLLEGE CORK   (Ireland)

^c UNIVERSITY COLLEGE HOSPITAL   (United Kingdom)

^d CITY UNIVERSITY   (United Kingdom)

^e KING'S COLLEGE LONDON   (United Kingdom)

^f MEMORIAL UNIVERSITY OF NEWFOUNDLAND   (Canada)

Author keywords

Hand hygiene; Hand hygiene audit; Hand hygiene compliance; Hawthorne effect; Health care associated infection; Observation of practice

Indexed keywords

BEHAVIOR ASSESSMENT; CLINICAL AUDIT; CLINICAL EFFECTIVENESS; CLINICAL PRACTICE; DATA ANALYSIS; HAND WASHING; HAWTHORNE EFFECT; HUMAN; INFECTION RISK; MEDICAL RESEARCH; MEDICAL SOCIETY; ORGANIZATIONAL EFFICIENCY; PATIENT ASSESSMENT; PATIENT COMPLIANCE; PRACTICE GUIDELINE; PUBLICATION; QUALITY CONTROL; REVIEW; RISK ASSESSMENT; RISK FACTOR; CROSS INFECTION; HEALTH SERVICES RESEARCH; INFECTION CONTROL; MANAGEMENT; PROCEDURES;

CROSS INFECTION; HAND HYGIENE; HEALTH SERVICES RESEARCH; HUMANS; INFECTION CONTROL; MANAGEMENT AUDIT;

EID: 84994805523     PISSN: 01956701     EISSN: 15322939     Source Type: Journal    
DOI: 10.1016/j.jhin.2016.08.008     Document Type: Review

References (66)

1. 1 Reybrouck, G., The role of hands in the spread of nosocomial infections. J Hosp Infect 4 (1983), 103–111.
2. 2 Teare, E.L., Cookson, B., French, G.L., et al. UK handwashing initiative. J Hosp Infect 43 (1999), 1–3.
3. 3 Boyce, J., Pittet, D., Guideline for hand hygiene in health care settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/DSA Hand Hygiene Task Force. Infect Control Hosp Epidemiol 23 (2002), S3–S41.
4. 4 Cookson, B., Mathal, E., Allegranzi, B., et al. Comparison of national and subnational guidelines for hand hygiene. J Hosp Infect 72 (2009), 202–210.
5. 5 World Health Organization, Guidelines on hand hygiene in health care. 2009, WHO, Geneva.
6. 6 Mathai, E., Allegranzi, B., Kilpatrick, C., Bagheri Nejad, S., Graafmans, W., Pittet, D., Promoting hand hygiene in healthcare through national/subnational campaigns. J Hosp Infect 77 (2011), 294–298.
7. 7 Gould, D.J., Moralejo, D., Drey, N.S., Chudleigh, J.H., Interventions to improve hand hygiene compliance in patient care (update). Cochrane Database Syst Rev(9), 2010, CD005186.
8. 8 Gould, D.J., Moralejo, D., Drey, N.S., Chudleigh, J., Measuring hand washing performance in health service audits and research studies. J Hosp Infect 66 (2007), 109–115.
9. 9 Gould, D.J., Drey, N., Creedon, S., Nemesis of hand hygiene audit. J Hosp Infect 77 (2011), 290–293.
10. 10 Haas, J.P., Larson, E.L., Measurement of compliance with hand hygiene. J Hosp Infect 66 (2007), 6–14.
11. 11 Chen, L.F., Carriker, C.C., Staheli, R., et al. Observing and improving hand hygiene compliance: implementation and refinement of an electronic-assisted direct-observer hand hygiene audit program. Infect Control Hosp Epidemiol 34 (2013), 207–210.
12. 12 Roethlisberger, F.J., Dickson, W.J., Wright, H.A., Pforzheimer, C.H., Western Electric Company. Management and the worker. 1939, Harvard University Press, Cambridge.
13. 13 Kompier, M.A.J., The ‘Hawthorne effect’ is a myth, but what keeps the story going?. Scand J Work Environ Health 32 (2006), 402–412.
14. 14 Levitt, S.D., List, J.A., Was there really a Hawthorne effect at the Hawthorne Plant? An analysis of the original illumination experiments. Am J Appl Econ 3 (2011), 224–238.
15. 15 Adair, J.G., The Hawthorne effect. A reconsideration of the methodological artifact. J Appl Psychol 69 (1984), 334–345.
16. 16 Holden, J.D., Hawthorne effect and research into professional practice. J Eval Clin Pract 7 (2008), 65–70.
17. 17 Diaper, G., The Hawthorne effect: a fresh examination. Educ Stud 16 (1990), 261–267.
18. 18 McCambridge, J., Witton, J., Elbourne, D.R., Systematic review of the Hawthorne effect: new concepts are needed to study research participation effects. J Clin Epidemiol 67 (2014), 267–277.
19. 19 Albert, R., Condie, F., Hand washing patterns in medical intensive care units. New Engl J Med 304 (1981), 1465–1466.
20. 20 Quaraishi, Z.A., McGuckin, M., Blals, F.X., et al. Duration of handwashing in intensive care units. A descriptive study. Am J Infect Control 18 (1984), 83–87.
21. 21 Gould, D.J., Nurses' handwashing practice: results of a local study. J Hosp Infect 28 (1994), 15–30.
22. 22 Pittet, D., Hugonnet, S., Mourouga, P., et al. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet 356 (2000), 1307–1312.
23. 23 Ho, M., Seto, W., Wong, L., Wong, T., Effectiveness of multifaceted hand hygiene interventions in long-term care facilities in Hong Kong: a cluster-randomized controlled trial. Infect Control Hosp Epidemiol 33 (2012), 761–767.
24. 24 Martin-Madrazo, C., Canada-Dorado, A., Salinero-Fort, M., et al. Effectiveness of a training programme to improve hand hygiene compliance in primary care. BMJ Publ Health 9 (2009), 1–8.
25. 25 Mertz, D., Dafoe, N., Walter, S.D., Brazil, K., Loeb, M., Effect of a multifaceted intervention on adherence to hand hygiene among healthcare workers: a cluster-randomized trial. Infect Control Hosp Epidemiol 31 (2010), 1170–1176.
26. 26 Eckmanns, T., Bessert, J., Behnke, M., Gastmeier, P., Ruden, H., Compliance with antiseptic hand rub use in intensive care units: the Hawthorne effect. Infect Control Hosp Epidemiol 27 (2006), 931–934.
27. 27 Pittet, D., Simon, A., Huggonet, S., Pessoa-Silva, C.L., Sauvan, V., Perneger, T.V., Hand hygiene among physicians: performance, beliefs and perceptions. Ann Intern Med 141 (2004), 1–8.
28. 28 Kohli, E., Ptak, J., Smith, S., et al. Variability in the Hawthorne Effect with regard to hand hygiene performance in high- and low-performing inpatient care units. Infect Control Hosp Epidemiol 30 (2009), 232–236.
29. 29 Al-Damouk, M., Pudney, E., Bleetman, A., Hand hygiene and aseptic technique in the emergency department. J Hosp Infect 56 (2004), 137–141.
30. 30 Dedrick, R., Sinkowitz-Cochran, R., Cunningham, C., et al. Hand hygiene practices after brief encounters with patients: an important opportunity for prevention. Infect Control Hosp Epidemiol 28 (2007), 341–345.
31. 31 Van de Mortel, T., Murgo, M., An examination of covert observation and solution audit as tools to measure the success of hand hygiene interventions. Am J Infect Control 34 (2006), 95–99.
32. 32 Potts, V., Devine, A., Cartright, A., Hand hygiene pays off. Can Nurse 106 (2010), 12–14.
33. 33 Whitby, M., McLaws, M.L., Slater, K., Tong, E., Johnson, B.I., Three successful interventions in health workers that improve compliance with hand hygiene: is sustained replication possible?. Am J Infect Control 36 (2008), 349–355.
34. 34 Mayer, J., Mooney, B., Gundlapalli, A., et al. Dissemination and sustainability of a hospital-wide hand hygiene program emphasizing positive reinforcement. Infect Control Hosp Epidemiol 32 (2010), 59–66.
35. 35 Tromp, M., Huis, A., de Guchteneire, I., et al. The short-term and long-term effectiveness of a multidisciplinary hand hygiene improvement program. Am J Infect Control 40 (2012), 732–736.
36. 36 Helder, O.K., Brug, J., Looman, C.W., van Goudoever, J.B., Kornelisse, R.F., The impact of an education program on hand hygiene compliance and nosocomial infection incidence in an urban neonatal intensive care unit: an intervention study with before and after comparison. Int J Nurs Stud 47 (2010), 1245–1252.
37. 37 Baum, C., Forehand, R., Zegiob, L., A review of observer reactivity in adult–child interactions. J Psychopath Behav Assess 1 (1979), 167–178.
38. 38 McCall, G., Systematic field observation. Annu Rev Sociol 10 (1984), 263–282.
39. 39 Rankin, C., Abrams, T., Barry, R., et al. Habituation revisited; an updated and revised description of the behavioral characteristics of habituation. Neurobiol Learn Mem 92 (2009), 135–138.
40. 40 Harbarth, S., Pittet, D., Grady, L., et al. Interventional study to evaluate the impact of an alcohol based hand gel in improving hand hygiene compliance. Paed Infect Dis J 21 (2002), 489–495.
41. 41 Cheng, V.C., Tai, J.W., Chan, W.M., et al. Sequential introduction of single room isolation and hand hygiene campaign in the control of methicillin-resistant Staphylococcus aureus in intensive care units. BMC Infect Dis 10 (2010), 263–265.
42. 42 Creedon, S.A., Health care workers' hand decontamination practices: compliance with recommended guidelines. J Adv Nurs 51 (2005), 208–216.
43. 43 Armellino, D., Hussain, E., Schilling, M.E., et al. Using high-technology to enforce low-technology safety measures: the use of third-party remote video auditing and real-time feedback in healthcare. Clin Infect Dis 54 (2012), 1–7.
44. 44 Lee, T.C., Moore, C., Raboud, J., et al. Impact of a mandatory infection control surveillance program on noscomial acquisition of methicillin-resistant Staphylococcus aureus. Infect Control Hosp Epidemiol 30 (2009), 249–256.
45. 45 Ebnother, C., Tanner, B., Schmid, F., La Rocca, V., Heinzer, I., Bregenzer, T., Impact of an infection control program on the prevalence of nosocomial infections at a tertiary care center in Switzerland. Infect Control Hosp Epidemiol 29 (2008), 38–43.
46. 46 Rose, L., Rogel, K., Redl, L., Cade, J.F., Implementation of a multimodal infection control program during an acinetobacter outbreak. Int Crit Care Nurs 25 (2009), 57–63.
47. 47 Sanchez-Paya, J., Fuster-Perez, M., Garcia-Gonzalez, R.M., et al. Evaluation of a program for updating recommendations about hand hygiene. An Sist Sanit Navar 30 (2007), 343–352.
48. 48 Pessoa-Silva, C.L., Hugonnet, S., Pfister, R., et al. Reduction of health care associated infection risk in neonates by successful hand hygiene promotion. Pediatrics 120 (2007), 382–390.
49. 49 Johnson, P.D.R., Martin, R., Burrell, L.J., et al. Efficacy of an alcohol/chlorhexidine hand hygiene program in a hospital with high rates of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection. Med J Aust 183 (2005), 509–514.
50. 50 McGuckin, M., Shubin, A., McBride, P., et al. The effect of random voice hand hygiene messages delivered by medical, nursing and infection control staff on hand hygiene compliance in intensive care. Am J Infect Control 34 (2006), 673–675.
51. 51 Miyachi, H., Furuya, H., Umezawa, K., et al. Controlling methicillin-resistant Staphylococcus aureus by stepwise implementation of preventive strategies in a university hospital: impact of a link-nurse system on the basis of multidisciplinary approaches. Am J Infect Control 35 (2007), 115–121.
52. 52 Harrington, G., Watson, K., Bailey, M., et al. Reduction in hospitalwide incidence of infection or colonization with methicillin-resistant Staphylococcus aureus and use of antimicrobial hand-hygiene gel and statistical process control charts. Infect Control Hosp Epidemiol 28 (2007), 837–844.
53. 53 Thomas, M., Gilespie, W., Krauss, J., et al. Focus group data as a tool in assessing effectiveness of a hand hygiene campaign. Am J Infect Control 33 (2006), 368–373.
54. 54 Sroka, S., Gastermeier, P., Meyer, B., Impact of alcohol hand rub use on meticillin-resistant Staphylococcus aureus: an analysis of the literature. J Hosp Infect 74 (2010), 204–210.
55. 55 Boscart, V.M., McGilton, K.S., Levchenko, A., Hufton, G., Holliday, P., Fernie, G.R., Acceptability of a wearable hand hygiene device with monitoring capabilities. J Hosp Infect 70 (2008), 216–222.
56. 56 Kinsella, G., Thomas, A.N., Taylor, R.J., Electronic surveillance of wall-mounted soap and alcohol gel dispensers in an intensive care unit. J Hosp Infect 66 (2007), 34–39.
57. 57 Dawson, C.H., McKrill, J.B., Review of technologies available to improve hand hygiene compliance: are they fit for purpose?. J Infect Prev 15 (2014), 222–228.
58. 58 Srigley, J.A., Furness, C.D., Baker, G.R., Gardam, M., Quantification of the Hawthorne effect in compliance monitoring: a retrospective cohort study. BMJ Qual Saf 23 (2014), 974–980.
59. 59 Hagel, S., Reischkle, J., Kesselmeier, M., et al. Quantifying the Hawthorne effect in hand hygiene compliance through comparing direct observation with automated hand hygiene monitoring. Infect Control Hosp Epidemiol 36 (2015), 957–962.
60. 60 Cheng, V.C.C., Tai, J., Ho, S.K.Y., Hung, K.N., Ho, P.L., Yuen, K.Y., Introduction of an electronic monitoring system for monitoring compliance with Moments 1 and 4 of the WHO ‘My 5 Moments for Hand Hygiene’ methodology. BMC Infect Dis 11 (2011), 151–163.
61. 61 Marra, A.R., Moura, D.F., Paes, A.T., dos Santos, O.F., Edmond, M.B., Measuring rates of hand hygiene adherence in the intensive care setting: a comparative study of direct observation, product usage and electronic counting devices. Infect Control Hosp Epidemiol 31 (2010), 796–801.
62. 62 Sax, H., Allegranzi, B., Uckay, I., Larson, E., Boyce, J., Pittet, D., My five moments for hand hygiene: a user-centred design approach to understanding, training, monitoring and reporting hand hygiene. J Hosp Infect 67 (2007), 9–21.
63. 63 Jeanes, A., Coen, P., Wilson, A.P.R., Drey, N., Gould, D.J., Collecting the data but missing the point: validity of hand hygiene audit data. J Hosp Infect 90 (2015), 156–162.
64. 64 Fuller, C., Michie, S., Savage, J., et al. The Feedback Intervention Trial (FIT) – improving hand-hygiene compliance in UK healthcare workers: a stepped wedge cluster randomised controlled trial. PLoS One, 7, 2012, e41617.
65. 65 Widmer, A.F., Conzelmann, M., Tomic, M., et al. Introducing alcohol-based rub for hand hygiene. The critical need for training. Infect Control Hosp Epidemiol 28 (2007), 50–54.
66. 66 Yeung, W.K., Tam, W.S., Wong, T.W., Cluster randomized controlled trial of a hand hygiene intervention involving pocket-sized containers of alcohol-based hand rub for the control of infections in long-term care facilities. Infect Control Hosp Epidemiol 32 (2011), 67–76.