title: Merging video coaching and an anthropologic approach to understand health care provider behavior toward hand hygiene protocols.
abstract: BACKGROUND
  We used videorecordings of routine care to analyze health care providers' deviance from protocols and organized follow-up interviews that were conducted by an anthropologist and a nurse.
  
  
  METHODS
  After consent, health care workers were recorded during routine care by an automatic video remote control. Each participant was invited to watch her or his recorded behaviors on 2 different videos showing routine practices and her or his deviance from protocols, and to comment on them. After this step an in-depth interview based on preestablished guidelines was organized and explanations regarding the observed deviance was discussed. This design was intended to reveal the HCWs' subjectivity; that is, how they perceive hand hygiene issues in their daily routine, what concrete difficulties they face, and how they try to resolve them.
  
  
  RESULTS
  We selected 43 of 250 videorecordings created during the study, which allowed us to study 15 out of 20 health care professionals. Twenty out of 43 videos showed 1 or more breaches in the hand hygiene protocol. The breaches were frequently linked to glove abuse. Deviance from protocols was explained by the health care workers as the result of an adaptive behavior; that is, facing work constraints that were disconnected from infection control protocols. Professional practices and protocols should be revisited to create simple messages that are adapted to the mandatory needs in a real life clinic environment.
authors.affiliation: URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095, Aix Marseille Université, Marseille, France; Infectious Disease Unit CHU Nord, Assistance Publique des Hôpitaux de Marseille, France; Institut Hospitalo-Universitaire IHU Méditerranée Infection, Marseille, France.
authors.forename: Sophia
authors.initials: S
authors.lastname: Boudjema
authors.affiliation: UMR912 SESSTIM (AMU-Inserm-IRD-AMSE), Aix Marseille University, Marseille, France; Institut Hospitalo-Universitaire IHU Méditerranée Infection, Marseille, France.
authors.forename: Clément
authors.initials: C
authors.lastname: Tarantini
authors.affiliation: UMR912 SESSTIM (AMU-Inserm-IRD-AMSE), Aix Marseille University, Marseille, France; BIOSTIC, Pôle de Santé Publique, Assistance Publique des Hôpitaux de Marseille, France; ORS PACA, Southeastern Health Regional Observatory, Marseille, France; Institut Hospitalo-Universitaire IHU Méditerranée Infection, Marseille, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Peretti-Watel
authors.affiliation: URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095, Aix Marseille Université, Marseille, France; Infectious Disease Unit CHU Nord, Assistance Publique des Hôpitaux de Marseille, France; Institut Hospitalo-Universitaire IHU Méditerranée Infection, Marseille, France. Electronic address: philippe.brouqui@univ-amu.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Brouqui
mesh_terms: D001291:Attitude of Health Personnel; D001521:Behavior Therapy; D004203:Disinfection / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D019983:Guideline Adherence; D063373:Hand Hygiene / Q000379:methods*; D006282:Health Personnel; D006801:Humans; D008297:Male; D000071252:Mentoring / Q000379:methods*; D014741:Video Recording
keywords: Anthropology; Behavior; Coaching; Glove abuse; Hand hygiene; Infection control; Social science; Video recording