Global Business School for Health, University College London, London, UK.
Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany.
J Hosp Infect. 2023 Nov;141:55-62. doi: 10.1016/j.jhin.2023.08.013. Epub 2023 Aug 25.
The increasing demand for outpatient care is associated with a higher risk of infection transmission in these settings. However, there is limited research on infection prevention and control practices in ambulatory clinics, and none focuses on patients.
To examine outpatients' hand hygiene behaviours, their determinants, and their associations with other infection prevention measures during the COVID-19 pandemic.
We observed the hand hygiene behaviour of one cohort of patients in one outpatient clinic and surveyed a separate sample in five clinics about their hand hygiene practice in outpatient facilities. A questionnaire based on the Theoretical Domains Framework (TDF) was used to examine predictors of the behaviour. Moreover, patients indicated their compliance with COVID-19 infection prevention measures, vaccination status, disease risk perception, and vaccine hesitancy.
Observed hand hygiene rates among 618 patients were low (12.8%), while 67.3% of the 300 surveyed patients indicated sanitizing their hands upon entering the clinic. The TDF domains 'memory, attention, and decision processes' and 'emotions' significantly predicted both current (today's) and general hand hygiene behaviour in outpatient clinics. Hand hygiene behaviour and compliance with COVID-19 infection prevention showed a positive association; however, no significant connection was found with patients' vaccination status, suggesting different behavioural motivators.
Hand hygiene among outpatients should be improved through interventions focusing on helping patients remember to clean their hands. More research on infection prevention in outpatient facilities is needed to ensure patient safety.
门诊需求的增加与这些环境中感染传播风险的增加有关。然而，关于门诊诊所的感染预防和控制实践的研究有限，并且没有一项研究关注患者。
调查门诊患者在 COVID-19 大流行期间的手卫生行为、其决定因素以及与其他感染预防措施的关联。
我们观察了一家门诊诊所的一组患者的手卫生行为，并对五家诊所的另一组患者进行了调查，了解他们在门诊设施中手卫生实践情况。使用基于理论领域框架（TDF）的问卷来检查行为的预测因素。此外，患者还表明了他们对 COVID-19 感染预防措施、疫苗接种状况、疾病风险感知和疫苗犹豫的遵守情况。
对 618 名患者进行观察，发现手卫生率较低（12.8%），而在接受调查的 300 名患者中，有 67.3%的患者表示在进入诊所时会消毒双手。“记忆、注意力和决策过程”和“情绪”这两个 TDF 领域显著预测了门诊患者当前（今日）和一般手卫生行为。手卫生行为和对 COVID-19 感染预防的遵守呈正相关；然而，与患者的疫苗接种状况没有显著联系，这表明存在不同的行为动机。
应通过关注帮助患者记住洗手的干预措施来提高门诊患者的手卫生水平。需要更多关于门诊设施感染预防的研究，以确保患者安全。
