Chatfield Sheryl L, Nolan Rachael, Crawford Hannah, Hallam Jeffrey S
Department of Social and Behavioral Sciences, College of Public Health, Kent State University, Kent, OH.
Department of Social and Behavioral Sciences, College of Public Health, Kent State University, Kent, OH.
Am J Infect Control. 2017 Jun 1;45(6):620-625. doi: 10.1016/j.ajic.2016.12.024. Epub 2017 Feb 21.
Hand hygiene is promoted as an effective practice to counter health care-acquired infections; however, compliance is less than optimal. Nurses have many patient contact opportunities and therefore are frequent participants in intervention research. The optimal combination of efficient and effective intervention components has not been conclusively identified.
A factorial survey research design offers an efficient method to assess multiple factors simultaneously by combining elements into vignettes. This article describes a process, grounded in the framework of Bandura's social cognitive theory, that explored environmental and individual factors that potentially influence nurses' hand hygiene behavior in acute care settings. Survey respondents consisted of nurses employed in patient care; respondents also could address an open response item.
A total of 466 participants scored a total of 3,685 vignettes. Statistically significant parameters included goal, supervisor priority, electronic monitoring, and rewards. The most frequently mentioned open response item was the need to keep hand hygiene product dispensers refilled. Participants also suggested that culture and intrinsic motivation influenced hand hygiene behavior.
Researchers might consider assessing promising factors, especially use of goal setting, as an intervention rather than as components of an intervention. Further research is indicated to better understand how nurses define and view hand hygiene culture.
手部卫生被推崇为预防医疗保健相关感染的有效措施；然而，其依从性并不理想。护士有很多与患者接触的机会，因此经常参与干预研究。高效且有效的干预要素的最佳组合尚未得到最终确定。
析因调查研究设计提供了一种通过将要素组合成小场景来同时评估多个因素的有效方法。本文描述了一个基于班杜拉社会认知理论框架的过程，该过程探讨了可能影响急症护理环境中护士手部卫生行为的环境和个体因素。调查对象包括从事患者护理工作的护士；受访者还可以回答一个开放式问题。
共有466名参与者对总共3685个小场景进行了评分。具有统计学意义的参数包括目标、上级重视程度、电子监控和奖励。最常被提及的开放式问题是需要保持手部卫生用品的供应。参与者还提出文化和内在动机影响手部卫生行为。
研究人员可能会考虑将评估有前景的因素，尤其是目标设定的使用，作为一种干预措施，而不是作为干预的组成部分。需要进一步研究以更好地理解护士如何定义和看待手部卫生文化。
