Price Lesley, Roome Karen, Lisa Ritchie, Reilly Jacqui, McIntyre Jackie, Godwin Jon, Bunyan Donald
Glasgow Caledonian University, Glasgow, United Kingdom.
Glasgow Caledonian University, Glasgow, United Kingdom.
Am J Infect Control. 2016 Jun 1;44(6):631-5. doi: 10.1016/j.ajic.2015.12.017. Epub 2016 Feb 5.
The World Health Organization describes that there are 5 moments during a health care encounter when hand hygiene should be performed. This research explores a number of explanatory hypotheses to inform future intervention development with regard to improving compliance with the fifth moment.
A sequential, mixed-methods study was conducted using nonparticipant observation and a survey with focus groups informing the development of the questionnaire. A total of 484 participants were observed and 410 returned a postobservation questionnaire; a response rate of 85%. Analysis explored the role of organizational culture, professional culture/practice, and individual-level variables in explaining compliance with the fifth moment.
Ninety-three percent of participants performed hand hygiene following the fifth moment. Compliance varied between regions, but not by professional group. More than 65% indicated that the fifth moment was clearly defined, achievable, valuable, encouraged, and widely known. However, 60% suggested that it was repetitive. There was a positive relationship between the performance of hand hygiene following the fifth moment and the perception that it was widely known.
Interventions to improve compliance with the fifth moment should focus on promoting awareness of the fifth moment and how it should be implemented in practice. Mechanisms for raising awareness should include education and role modeling.
世界卫生组织指出，在医疗保健过程中有5个时刻应进行手部卫生清洁。本研究探索了一些解释性假设，为未来关于提高对第五个时刻的依从性的干预措施开发提供参考。
采用非参与观察和焦点小组调查的顺序混合方法进行研究，焦点小组调查为问卷的开发提供信息。共观察了484名参与者，410人返回了观察后的问卷，回复率为85%。分析探讨了组织文化、专业文化/实践和个体层面变量在解释对第五个时刻的依从性方面的作用。
93%的参与者在第五个时刻后进行了手部卫生清洁。依从性在不同地区有所差异，但在不同专业群体中没有差异。超过65%的人表示第五个时刻定义明确、可实现、有价值、受到鼓励且广为人知。然而，60%的人认为这一时刻具有重复性。在第五个时刻后进行手部卫生清洁的行为与认为其广为人知之间存在正相关关系。
提高对第五个时刻依从性的干预措施应侧重于提高对第五个时刻的认识以及在实践中应如何实施。提高认识的机制应包括教育和榜样示范。
