A survey of acute care clinicians' views on factors influencing hand hygiene practice and actions to improve hand hygiene compliance

• Acute care clinicians are receptive to a range of system and practitioner-focused strategies to improve compliance, including defining hand hygiene lapses as a healthcare error.
• When designing and implementing hand hygiene improvement strategies, the views of staff from different clinical disciplines should be taken into account.

IntroductionHand hygiene best practice compliance rates are low in acute care settings despite investment in strategies in the acute care setting to improve hand hygiene practice. Knowledge of local influences such as health professionals' views on current strategies and influential factors is required to develop effective and sustainable interventions.MethodsA single-centre cross-sectional survey was conducted to identify the views of 300 randomly sampled acute care health professionals from a tertiary referral teaching hospital, on the factors that they believe influence hand hygiene practice, and their views on strategies to improve compliance. Data were collected using a 19-question self-administered questionnaire and were analysed using descriptive statistics and chi-square tests to analyse differences between the clinical disciplines.ResultsThe sample response rate was 39% (n = 118). Doctors were significantly less likely to report receiving hand hygiene education (p < 0.01) or familiarity with the five moments for hand hygiene (p < 0.01). Overall, respondents regarded organisational strategies more favourably than clinician or patient-focused strategies. Medical staff were less likely to agree with clinical area hand hygiene performance feedback (p = 0.03) while nursing staff were more likely to be agreeable to regular hand hygiene assessment (p = 0.02).ConclusionHand hygiene education may require targeting of particular groups of health professionals to ensure that all clinical disciplines receive hand hygiene education. Hand hygiene strategies should be based on local needs and take into account contextual factors.