King Dominic, Vlaev Ivo, Everett-Thomas Ruth, Fitzpatrick Maureen, Darzi Ara, Birnbach David J
Centre for Health Policy, Imperial College London.
Warwick Business School, University of Warwick.
Health Psychol. 2016 Jan;35(1):96-101. doi: 10.1037/hea0000239. Epub 2015 Jul 27.
Effective hand hygiene is the single most important procedure in preventing hospital-acquired infections. Traditional information/education-based interventions have shown only modest benefits on compliance. This study set out to investigate whether priming via olfactory and visual cues influences hand hygiene compliance.
Randomized controlled trial set in a surgical intensive care unit (SICU) at a teaching hospital in Miami, Florida. The primary outcome data involved observations-a mix of health professionals and service users were observed entering the SICU by 2 trained observers and their hand hygiene compliance was independently verified. Interventions included either an olfactory prime (clean, citrus smell) or visual prime (male or female eyes). The primary outcome measure was hand hygiene compliance (HHC) measured by the visitor using the hand gel dispenser.
At a 5% level there was significant evidence that a clean, citrus smell significantly improves HHC (46.9% vs. 15.0%, p = .0001). Compared to the control group, a significant improvement in HHC was seen when a picture of "male eyes" was placed over the hand gel dispenser (33.3% vs. 15.0%, p < .038). No significant improvement in HHC was seen when a picture of female eyes was placed over the same hand gel dispenser (10.0% vs. 15.0%, p = .626).
This is one of the first studies to demonstrate that priming can influence HHC in a clinical setting. The findings suggest that priming interventions could be used to change other behaviors relevant to public health.
有效的手部卫生是预防医院获得性感染的最重要的单一程序。传统的基于信息/教育的干预措施在提高依从性方面仅显示出适度的益处。本研究旨在调查通过嗅觉和视觉线索进行启动是否会影响手部卫生依从性。
在佛罗里达州迈阿密一家教学医院的外科重症监护病房（SICU）进行随机对照试验。主要结局数据包括观察——由2名经过培训的观察员观察医护人员和服务使用者进入SICU的情况，并独立核实他们的手部卫生依从性。干预措施包括嗅觉启动（清洁的柑橘气味）或视觉启动（男性或女性的眼睛图片）。主要结局指标是访客使用洗手液时的手部卫生依从性（HHC）。
在5%的水平上，有显著证据表明，清洁的柑橘气味能显著提高手部卫生依从性（46.9%对15.0%，p = .0001）。与对照组相比，当在洗手液分配器上方放置“男性眼睛”图片时，手部卫生依从性有显著提高（33.3%对15.0%，p < .038）。当在同一洗手液分配器上方放置女性眼睛图片时，手部卫生依从性没有显著提高（10.0%对15.0%，p = .626）。
这是首批证明启动可在临床环境中影响手部卫生依从性的研究之一。研究结果表明，启动干预措施可用于改变与公共卫生相关的其他行为。
