Craig Christina E, Schnorr Charles D, Then Paulino Cecilia J, Payano Eulogia Cristina, Guzmán Paloma Martínez, Ripkey Carrie, de St Aubin Michael, Dumas Devan, Roberts Kathryn W, Duke William, Skewes-Ramm Ronald, Lozier Matthew J, Nilles Eric J
National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Infect Prev Pract. 2024 May 1;6(2):100367. doi: 10.1016/j.infpip.2024.100367. eCollection 2024 Jun.
Proper hand hygiene (HH), which includes sanitizing with alcohol-based hand rub (ABHR) (or handwashing with soap and water if ABHR is unavailable), is key for preventing healthcare-associated infections (HCAI), including COVID-19. Understanding drivers of HH is key to improving adherence.
This study aims to explore drivers and barriers to HH practice at two hospitals in the Dominican Republic in the context of the COVID-19 pandemic to inform development of HH behaviour change interventions.
We conducted in-depth interviews with 20 hospital staff during September 2021. We used the COM-B (capability, opportunity, motivation, behaviour) model to explore HH experiences and preferences. Interviews were recorded, transcribed, coded, and analysed using a thematic approach.
A total of 11 parent codes and 27 sub-codes were identified, and 1145 coded segments were analysed. Use of handwashing with soap and water and/or sanitizing with ABHR was reported by all participants; handwashing was generally preferred. Participants expressed knowledge of proper HH methods (capability), but inconsistent supplies and lack of time presented HH challenges (opportunity). Interviewees described practicing HH to protect themselves and their families from COVID-19 and other infections (reflective motivation) or out of habit (automatic motivation).
By understanding and addressing underlying factors affecting HH, hospitals can decrease the risk of HCAIs. Our findings suggest that interventions implemented to improve HH in these hospitals should target motivation and opportunity. These findings informed a multimodal intervention to increase ABHR access and implement message-tested communications campaigns; end-point assessments will provide insights into the intervention's impact.
正确的手部卫生（HH），包括使用酒精类洗手液（ABHR）进行消毒（如果没有ABHR，则用肥皂和水洗手），是预防包括COVID-19在内的医疗保健相关感染（HCAI）的关键。了解手部卫生的驱动因素是提高依从性的关键。
本研究旨在探讨在COVID-19大流行背景下，多米尼加共和国两家医院手部卫生实践的驱动因素和障碍，为手部卫生行为改变干预措施的制定提供信息。
2021年9月，我们对20名医院工作人员进行了深入访谈。我们使用COM-B（能力、机会、动机、行为）模型来探讨手部卫生的经历和偏好。访谈进行了录音、转录、编码，并采用主题分析法进行分析。
共识别出11个父代码和27个子代码，并分析了1145个编码片段。所有参与者都报告了使用肥皂和水洗手和/或使用ABHR进行消毒的情况；一般更喜欢洗手。参与者表示了解正确的手部卫生方法（能力），但供应不一致和时间不足给手部卫生带来了挑战（机会）。受访者表示进行手部卫生是为了保护自己和家人免受COVID-19和其他感染（反思性动机）或出于习惯（自动动机）。
通过了解和解决影响手部卫生的潜在因素，医院可以降低医疗保健相关感染的风险。我们的研究结果表明，为改善这些医院的手部卫生而实施的干预措施应针对动机和机会。这些研究结果为增加ABHR可及性和开展经过信息测试的宣传活动的多模式干预提供了依据；终点评估将提供有关干预影响的见解。
