title: Reflection on observation: A qualitative study using practice development methods to explore the experience of being a hand hygiene auditor in Australia.
abstract: BACKGROUND
  Within the Australian public health care system, an observation model is used to assess hand hygiene practice in health care workers, culminating in a publicly available healthcare service performance indicator. The intent of this study was for the results to inform the development of a strategy to support individual auditors and local sustainability of the hand hygiene auditing program.
  
  
  METHODS
  This qualitative study used a values clarification tool to gain an understanding of the experiences of hand hygiene auditors. The methodology involved qualitative interpretation of focus group discussions to identify the enablers and barriers to successful performance of the auditors' role.
  
  
  RESULTS
  Twenty-five participants identified congruous themes of the need for peer and managerial support, improved communication and feedback, and consideration for succession planning. There was consistency in the participants' most frequently identified significant barriers in undertaking the role.
  
  
  CONCLUSIONS
  Hand hygiene auditors take pride in their role and work toward the goal of reducing health care-associated infections by having a part to play in improving hand hygiene practices of all staff members. Important themes, barriers, and enablers were identified in this study. This research will be of interest nationally and globally, considering the dearth of published information on the experience of hand hygiene auditors. This study provides evidence of the need to support individual hand hygiene auditors.
authors: Centre for Healthcare Epidemiology and Staff Services, Prince of Wales Hospital, Sydney, NSW, Australia.
authors: Susan
authors: S
authors: Jain
authors: Nursing Practice and Research Development Unit, Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia.
authors: Denise
authors: D
authors: Edgar
authors: St George Hospital and Community Service, Kogarah, NSW, Australia.
authors: Janine
authors: J
authors: Bothe
authors: Infection Management and Control Service (IMACS), Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia.
authors: Helen
authors: H
authors: Newman
authors: Infection Management and Control Service (IMACS), Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia.
authors: Annmaree
authors: A
authors: Wilson
authors: Infection Management and Control Service (IMACS), Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia.
authors: Beth
authors: B
authors: Bint
authors: Infection Management and Control Service (IMACS), Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia.
authors: Megan
authors: M
authors: Brown
authors: Infection Management and Control Service (IMACS), Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia.
authors: Suzanne
authors: S
authors: Alexander
authors: Infection Management and Control Service (IMACS), Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia. Electronic address: Joanna.harris@sesiahs.health.nsw.gov.au.
authors: Joanna
authors: J
authors: Harris
mesh_terms: D001315:Australia; D003428:Cross Infection / Q000517:prevention & control*; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D019983:Guideline Adherence / Q000592:standards*; D063373:Hand Hygiene / Q000379:methods* / Q000592:standards*; D006268:Health Facilities; D006282:Health Personnel; D006801:Humans; D011786:Quality Control
keywords: Habits; Hand hygiene audit; Health personnel; Infection control; Organizational culture; Practice development