Afework Abel, Tamene Aiggan
Center for Sustainable Development, Addis Ababa University, Addis Ababa, Ethiopia.
Center for Sustainability, University of Otago, Dunedin, New Zealand.
BMC Infect Dis. 2025 Apr 10;25(1):502. doi: 10.1186/s12879-025-10924-4.
Hand hygiene is the most effective and feasible infection prevention and control measure within the healthcare facilities. Despite the ease and simplicity of the technique, the adherence rate among health professionals remains suboptimal. Hence, developing targeted interventions to improve adherence requires a clear understanding of these obstacles. Therefore, this systematic reviews of existing literature aims to fully understand the context specific barriers of hand hygiene to answer why barriers persisted despite the interventions to maintaining hand hygiene practices among healthcare providers.
This systematic review was conducted to synthesize existing evidence according to the Joanna Briggs Institute (JBI) qualitative studies review methodology on qualitative studies publish between the year 2010 and 2024. The study is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guideline (PRISMA) and the protocol for the study was published on PROSPERO (CRD42024573753) before commencing the study.
The review included twenty eight studies that are conducted in different regions of the world representing six of the continents. The study identified four interconnected themes of barriers with many subthemes. Behavioural barriers and organizational barriers were the most highlighted themes within the review. Physical barriers were one of the significant themes, where unavailability and inconvenience of hand hygiene resources gain the most attention by study participants across the studies. The fourth theme was societal/interpersonal barriers characterized by negative social influence and unsupportive colleagues.
The study highlights that the barriers to hand hygiene adherence among healthcare professionals are intertwined and complex, with the main interplaying among behavioural, societal/interpersonal, physical, and organizational barriers. The findings underscore that the intertwined nature of these barriers requires a multifaceted approach involving the relevant stakeholders to improve hand hygiene adherence among healthcare providers.
手部卫生是医疗机构内最有效且可行的感染预防与控制措施。尽管该技术简便易行，但卫生专业人员的依从率仍不理想。因此，制定有针对性的干预措施以提高依从性需要清楚了解这些障碍。所以，本次对现有文献的系统综述旨在全面了解特定背景下的手部卫生障碍，以回答为何尽管采取了干预措施，医疗服务提供者在坚持手部卫生做法方面的障碍依然存在。
本系统综述依据乔安娜·布里格斯研究所（JBI）定性研究综述方法，对2010年至2024年间发表的定性研究进行综合分析。该研究按照系统评价和Meta分析的首选报告项目指南（PRISMA）进行报告，研究方案在研究开始前已在国际前瞻性系统评价注册库（PROSPERO，注册号：CRD42024573753）上发表。
该综述纳入了来自世界不同地区、代表六大洲中的六个地区的28项研究。研究确定了四个相互关联的障碍主题及许多子主题。行为障碍和组织障碍是综述中最突出的主题。物理障碍是重要主题之一，其中手部卫生资源的不可用和不便在各项研究中最受参与者关注。第四个主题是社会/人际障碍，其特点是负面社会影响和不支持的同事。
该研究强调，医疗专业人员在手部卫生依从性方面的障碍相互交织且复杂，主要体现在行为、社会/人际、物理和组织障碍之间的相互作用。研究结果强调，这些障碍的相互交织性质需要多方面的方法，涉及相关利益攸关方，以提高医疗服务提供者的手部卫生依从性。
