title: Systematic review of the effectiveness of strategies to encourage patients to remind healthcare professionals about their hand hygiene.
abstract: BACKGROUND
  Patients could help to improve the hand hygiene (HH) compliance of healthcare professionals (HCPs) by reminding them to sanitize their hands.
  
  
  OBJECTIVE
  To review the effectiveness of strategies aimed at increasing patient involvement in reminding HCPs about their HH.
  
  
  METHODS
  A systematic review was conducted across Medline, EMBASE and PsycINFO between 1980 and 2013.
  
  
  RESULTS
  Twenty-eight out of a possible 1956 articles were included. Of these, 23 articles evaluated the effectiveness of developed patient-focused strategies and five articles examined patients' attitudes towards hypothetical strategies. Sixteen articles evaluated single-component strategies (e.g. videos) and 12 articles evaluated multi-modal approaches (e.g. combination of video and leaflet). Overall, the strategies showed promise in helping to increase patients' intentions and/or involvement in reminding HCPs about their HH. HCP encouragement appeared to be the most effective strategy. However, the methodological quality of the articles in relation to addressing the specific aims of this review was generally weak.
  
  
  CONCLUSIONS
  A number of strategies are available to encourage patients to question HCPs about their HH. Better controlled studies with more robust outcome measures will enhance understanding about which strategies may be most successful and why.
authors.affiliation: Centre for Patient Safety and Service Quality, Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK. Electronic address: rachel.davis@imperial.ac.uk.
authors.forename: R
authors.initials: R
authors.lastname: Davis
authors.affiliation: Centre for Patient Safety and Service Quality, Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Parand
authors.affiliation: Centre for Patient Safety and Service Quality, Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Pinto
authors.affiliation: Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, Auckland, New Zealand.
authors.forename: S
authors.initials: S
authors.lastname: Buetow
mesh_terms: D063373:Hand Hygiene / Q000379:methods* / Q000592:standards; D006282:Health Personnel / Q000941:ethics; D006801:Humans; D017053:Infection Control / Q000379:methods*; D017757:Infectious Disease Transmission, Professional-to-Patient / Q000517:prevention & control; D010358:Patient Participation / Q000379:methods*; D017010:Reminder Systems
keywords: Hand hygiene compliance; Hospital-acquired infections; Patient involvement; Systematic review