1120. The Role of Healthcare Workers’ Behavior on Compliance to Five Moments Hand Hygiene
Session: Oral Abstract Session: Improving Healthcare Worker Hand Hygiene Adherence
Friday, October 4, 2013: 2:15 PM
Room: The Moscone Center: 200-212
Background: The World Health Organization (WHO) has introduced “My Five Moments for Hand Hygiene” (5MHH) as a recommended standard in 2009 to optimize hand hygiene (HH).  To date, the uptake of these recommendations by healthcare workers’ (HCWs) remains uncertain.

Methods: We prospectively observed HCWs’ compliance to 5MHH in various hospital units at a Thai medical center.  Post-observation, HCWs completed interviews for HH practices using behavioral constructs from the Transtheoretical Model of Health Behavior Change (TTM) and the Theory of Planned Behavior (TPB).  Factors associated with HH compliance were separately analyzed based on each behavioral theory.

Results: There were 968 observations among 123 HCWs, of whom 110 (89.4%) were female, 63 (51.3%) were nurses, and the mean age was 26.9 years (95% CI = 26.1-27.7).  Among the 968 observations, 411 (42.5%) were in critical care units (CCU). Overall, mean 5MHH compliance by direct observation was 23.2% (95% CI = 18.1-28.3).  Most HCWs belonged to the stage of maintenance (67.5%) and the stage of action (17.9%) based on TTM.  Working in CCU (P < 0.05), working in Medicine Department (P = 0.08, P < 0.001), caring of immunocompromised patient (P < 0.05), and concerning patient’s advantage as the first priority (P < 0.001) were associated with HH compliance in both TTM and TPB models.  Being in the stage of Action and Maintenance (P = 0.08) and extremely positive attitude toward 5MHH (P = 0.04) were associated with HH compliance in TTM and TPB models, respectively.  The HCWs in higher stages of behavior change had higher compliance to observed (P = 0.04) and self-reported (P = 0.01) 5MHH than those in the lower stages based on TTM.  The total TPB behavior score correlated significantly with observed (r = 0.21, P = 0.02) and with self-reported compliance (r = 0.53, P< 0.001) to 5MHH.

Conclusion: Compliance to 5MHH was associated with unit cultures, patients’ characteristics, and HCWs observed and self-report of HH stages of Action and Maintenance.

Anucha Apisarnthanarak, MD1, Thanee Eiamsitrakoon2, Winitra Nuallaong3, Thana Khawcharoenporn, MD1 and Linda Mundy, MD4, (1)Thammasat University, Pathumthani, Thailand, (2)Department of Medicine, Thammasat University Hospital, Pratumthani, Thailand, (3)Department of Phychiatry, Pratumthani, Thailand, (4)LM Mundy, Pennsylvania, PA


A. Apisarnthanarak, None

T. Eiamsitrakoon, None

W. Nuallaong, None

T. Khawcharoenporn, None

L. Mundy, None

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