Institute for Patient Safety, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.
University of Applied Sciences and Arts Northwestern Switzerland, FHNW School of Applied Psychology, Olten, Switzerland.
BMC Health Serv Res. 2019 Aug 5;19(1):547. doi: 10.1186/s12913-019-4347-z.
Effective hand hygiene is one of the most important measures for protecting nursing home residents from nosocomial infections. Infections with multi-resistant bacteria's, associated with healthcare, is a known problem. The nursing home setting differs from other healthcare environments in individual and organisational factors such as knowledge, behaviour, and attitude to improve hand hygiene and it is therefore difficult to research the influential factors to improve hand hygiene. Studies have shown that increasing knowledge, behaviour and attitudes could enhance hand hygiene compliance in nursing homes. Therefore, it may be important to examine individual and organisational factors that foster improvement of these factors in hand hygiene. We aim to explore these influences of individual and organisational factors of hand hygiene in nursing home staff, with a particular focus on the function of role modelling by nursing managers.
We conducted a mixed-methods study surveying 165 nurses and interviewing 27 nursing managers from nursing homes in Germany.
Most nurses and nursing managers held the knowledge of effective hand hygiene procedures. Hygiene standards and equipment were all generally available but compliance to standards also depended upon availability in the immediate work area and role modelling. Despite a general awareness of the impact of leadership on staff behaviour, not all nursing managers fully appreciated the impact of their own consistent role modelling regarding hand hygiene behaviours.
These results suggest that improving hand hygiene should focus on strategies that facilitate the provision of hand disinfectant materials in the immediate work area of nurses. In addition, nursing managers should be made aware of the impact of their role model function and they should implement this in daily practice.
有效的手部卫生是保护养老院居民免受医院感染的最重要措施之一。与医疗保健相关的多重耐药菌感染是已知的问题。养老院的环境在知识、行为和态度等个人和组织因素方面与其他医疗环境不同，这些因素会影响手部卫生的改善，因此很难研究影响手部卫生改善的因素。研究表明，增加知识、行为和态度可以提高养老院的手部卫生依从性。因此，检查促进手部卫生这些因素改善的个人和组织因素可能很重要。我们旨在探讨养老院工作人员手部卫生的个人和组织因素的这些影响，特别关注护理经理的榜样作用。
我们进行了一项混合方法研究，对德国养老院的 165 名护士进行了调查，并对 27 名护理经理进行了访谈。
大多数护士和护理经理都了解有效的手部卫生程序知识。卫生标准和设备都普遍可用，但标准的遵守程度也取决于工作区域的可用性和榜样作用。尽管普遍意识到领导力对员工行为的影响，但并非所有护理经理都充分意识到自己在手部卫生行为方面的持续榜样作用的影响。
这些结果表明，改善手部卫生应侧重于促进在护士的工作区域提供手部消毒剂材料的策略。此外，应使护理经理意识到他们的榜样作用的影响，并在日常实践中实施这一点。
