title: Role of parents in the promotion of hand hygiene in the paediatric setting: a systematic literature review.
abstract: BACKGROUND
  When a child is hospitalized, parents have to share their role to protect the child with the hospital, and establish a partnership with healthcare workers to deliver safe care to the child, including undertaking good hand hygiene practices.
  
  
  OBJECTIVE
  To review the scientific evidence about the participation of parents in the promotion of hand hygiene in paediatric settings.
  
  
  METHODS
  A systematic search of MEDLINE, EMBASE and SciELO databases was undertaken using the following terms: ('hand hygiene'[MeSH] OR 'hand hygiene' OR 'hand disinfection'[MeSH] OR hand disinf* OR hand wash* OR handwash* OR hand antisep*) AND (parent OR caregiver OR mother OR father OR family OR families OR relatives). The Integrated Quality Criteria for Review of Multiple Study Designs tool was used for quality assessment.
  
  
  RESULTS
  The literature search yielded 1645 articles, and 11 studies met the inclusion criteria for the final analysis. Most studies were observational, and were based on questionnaires or interviews. Most parents had little knowledge about the indications to perform hand hygiene, but recognized hand hygiene as a relevant tool for the prevention of healthcare-associated infections. Their willingness to remind healthcare workers about a failed opportunity to perform hand hygiene was variable and, overall, rather low. Parents felt more comfortable about reminding healthcare workers about hand hygiene if they had previously been invited to do so.
  
  
  CONCLUSIONS
  Literature on the subject is scarce. The promotion of hand hygiene by parents should be further explored by research as a potential intervention for enhancing patient safety in paediatric settings.
authors.affiliation: Infection Control Programme and World Health Organization Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland; Social Medicine Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
authors.forename: F
authors.initials: F
authors.lastname: Bellissimo-Rodrigues
authors.affiliation: Infection Control Programme and World Health Organization Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
authors.forename: D
authors.initials: D
authors.lastname: Pires
authors.affiliation: Infection Control Programme and World Health Organization Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
authors.forename: W
authors.initials: W
authors.lastname: Zingg
authors.affiliation: Infection Control Programme and World Health Organization Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland. Electronic address: didier.pittet@hcuge.ch.
authors.forename: D
authors.initials: D
authors.lastname: Pittet
mesh_terms: D063373:Hand Hygiene / Q000379:methods*; D006266:Health Education / Q000379:methods*; D006801:Humans; D017053:Infection Control / Q000379:methods*; D010290:Parents
keywords: Hand hygiene; Paediatrics; Parents; Partnership; Patient participation; Systematic review