title: Influence of role models and hospital design on hand hygiene of healthcare workers.
abstract: We assessed the effect of medical staff role models and the number of health-care worker sinks on hand-hygiene compliance before and after construction of a new hospital designed for increased access to handwashing sinks. We observed health-care worker hand hygiene in four nursing units that provided similar patient care in both the old and new hospitals: medical and surgical intensive care, hematology/oncology, and solid organ transplant units. Of 721 hand-hygiene opportunities, 304 (42%) were observed in the old hospital and 417 (58%) in the new hospital. Hand-hygiene compliance was significantly better in the old hospital (161/304; 53%) compared to the new hospital (97/417; 23.3%) (p<0.001). Health-care workers in a room with a senior (e.g., higher ranking) medical staff person or peer who did not wash hands were significantly less likely to wash their own hands (odds ratio 0.2; confidence interval 0.1 to 0.5); p<0.001). Our results suggest that health-care worker hand-hygiene compliance is influenced significantly by the behavior of other health-care workers. An increased number of hand-washing sinks, as a sole measure, did not increase hand-hygiene compliance.
authors.affiliation: Northwestern Prevention Epicenter, Chicago, Illinois, USA.
authors.forename: Mary G
authors.initials: MG
authors.lastname: Lankford
authors.forename: Teresa R
authors.initials: TR
authors.lastname: Zembower
authors.forename: William E
authors.initials: WE
authors.lastname: Trick
authors.forename: Donna M
authors.initials: DM
authors.lastname: Hacek
authors.forename: Gary A
authors.initials: GA
authors.lastname: Noskin
authors.forename: Lance R
authors.initials: LR
authors.lastname: Peterson
mesh_terms: D000891:Anti-Infective Agents, Local; D001291:Attitude of Health Personnel; D017575:Gloves, Protective; D006235:Hand Disinfection / Q000592:standards*; D006282:Health Personnel; D006749:Hospital Design and Construction; D006761:Hospitals / Q000592:standards; D006801:Humans; D006920:Hygiene; D016272:Occupational Health; D016017:Odds Ratio; D005791:Patient Care; D012380:Role; D013997:Time Factors
chemical_list: D000891:Anti-Infective Agents, Local