title: Culture change in infection control: applying psychological principles to improve hand hygiene.
abstract: Hand hygiene occurs at the intersection of habit and culture. Psychological and social principles, including operant conditioning and peer pressure of conforming social norms, facilitate behavior change. Participatory leadership and level hierarchies are needed for sustainable patient safety culture. Application of these principles progressively and significantly improved hand hygiene compared with the hospital aggregate control. Changes to hand hygiene auditing and response processes demonstrate ability to improve and sustain adherence rates within a clinical microsystem.
authors.affiliation: University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO 80045, USA. Ethan.Cumbler@ucdenver.edu
authors.forename: Ethan
authors.initials: E
authors.lastname: Cumbler
authors.forename: Leilani
authors.initials: L
authors.lastname: Castillo
authors.forename: Laura
authors.initials: L
authors.lastname: Satorie
authors.forename: Deborah
authors.initials: D
authors.lastname: Ford
authors.forename: Jan
authors.initials: J
authors.lastname: Hagman
authors.forename: Therese
authors.initials: T
authors.lastname: Hodge
authors.forename: Lisa
authors.initials: L
authors.lastname: Price
authors.forename: Heidi
authors.initials: H
authors.lastname: Wald
mesh_terms: D002408:Catheters, Indwelling / Q000382:microbiology*; D003120:Colorado; D003428:Cross Infection / Q000517:prevention & control*; D006235:Hand Disinfection / Q000592:standards*; D006801:Humans; D006920:Hygiene / Q000193:education* / Q000592:standards*; D017053:Infection Control / Q000592:standards*; D008485:Medical Audit; D015279:Organizational Culture; D061214:Patient Safety / Q000592:standards*; D010379:Peer Group; D010564:Personnel, Hospital / Q000193:education* / Q000523:psychology*; D058996:Quality Improvement; D012201:Reward