Using a theory of planned behaviour framework to explore hand hygiene beliefs at the '5 critical moments' among Australian hospital-based nurses

White, K, Jimmieson, N, Obst, P, Graves, N, Barnett, A, Cockshaw, W, Gee, P, Haneman, L, Page, K, Campbell, M, Martin, E and Paterson, D 2015, 'Using a theory of planned behaviour framework to explore hand hygiene beliefs at the '5 critical moments' among Australian hospital-based nurses', BMC Health Services Research, vol. 15, no. 1, pp. 1-9.


Document type: Journal Article
Collection: Journal Articles

Title Using a theory of planned behaviour framework to explore hand hygiene beliefs at the '5 critical moments' among Australian hospital-based nurses
Author(s) White, K
Jimmieson, N
Obst, P
Graves, N
Barnett, A
Cockshaw, W
Gee, P
Haneman, L
Page, K
Campbell, M
Martin, E
Paterson, D
Year 2015
Journal name BMC Health Services Research
Volume number 15
Issue number 1
Start page 1
End page 9
Total pages 9
Publisher BioMed Central
Abstract Background: Improving hand hygiene among health care workers (HCWs) is the single most effective intervention to reduce health care associated infections in hospitals. Understanding the cognitive determinants of hand hygiene decisions for HCWs with the greatest patient contact (nurses) is essential to improve compliance. The aim of this study was to explore hospital-based nurses ' beliefs associated with performing hand hygiene guided by the World Health Organization's (WHO) 5 critical moments. Using the belief-base framework of the Theory of Planned Behaviour, we examined attitudinal, normative, and control beliefs underpinning nurses' decisions to perform hand hygiene according to the recently implemented national guidelines. Methods: Thematic content analysis of qualitative data from focus group discussions with hospital-based registered nurses from 5 wards across 3 hospitals in Queensland, Australia. Results: Important advantages (protection of patient and self), disadvantages (time, hand damage), referents (supportive: patients, colleagues; unsupportive: some doctors), barriers (being too busy, emergency situations), and facilitators (accessibility of sinks/products, training, reminders) were identified. There was some equivocation regarding the relative importance of hand washing following contact with patient surroundings. Conclusions: The belief base of the theory of planned behaviour provided a useful framework to explore systematically the underlying beliefs of nurses ' hand hygiene decisions according to the 5 critical moments, allowing comparisons with previous belief studies. A commitment to improve nurses' hand hygiene practice across the 5 moments should focus on individual strategies to combat distraction from other duties, peer-based initiatives to foster a sense of shared responsibility, and management-driven solutions to tackle staffing and resource issues. Hand hygiene following touching a patient's surroundings continues to be reported as the mo
Subject Health, Clinical and Counselling Psychology
Keyword(s) Infection prevention
Health care-associated infections
Nurses
Attitudes
Barriers
Theory of planned behaviour
DOI - identifier 10.1186/s12913-015-0718-2
Copyright notice © 2015 White et al.
ISSN 1472-6963
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