Social cohesion: The missing factor required for a successful hand hygiene program - 18/04/17
Highlights |
• | Interviews exploring satisfaction with an automated hand hygiene surveillance system identified 2 factors that were present in only the ward that responded to daily rates and a behavioral intervention requiring staff to remind each other to comply. |
• | Clinicians on both wards held positive hand hygiene beliefs, but compliance was different. |
• | Nudging others to comply requires social cohesion between the professions. |
• | Clinicians on the socially cohesive ward described a well-liked leader. |
• | Social cohesiveness and positive ward culture were absent from the ward that did not improve compliance. |
Abstract |
Background |
There are limited explorations into hospital staff reactions to automated hand hygiene surveillance or hand hygiene interventions.
Methods |
An automated surveillance system with daily feedback and a behavioral intervention component was trialed in 2 wards in an Australian tertiary teaching hospital. After 9 months, 12 clinicians from each ward were interviewed prior to the completion of the trial to explore satisfaction with the system and behavioral component of nudging each other with a reminder to comply. Only on completion of the trial were transcripts analyzed for themes.
Results |
Staff from the ward with improved compliance described a socially cohesive team with a well-liked nurse unit manager who accessed daily compliance rates and worked with staff to set goals. This contrasted with the ward without improvement in compliance, whose staff described their great reluctance and discomfort to nudge each other to comply and distrust of the authenticity of the rates established from the automated system.
Conclusions |
Interventions for improving compliance are more likely to be successful in a ward with a social cohesive team. Patient safety interventions, in the first instance, may benefit from purposeful selection of wards with cohesive teams and skilled leaders who can transform clinicians into early adopters of the program.
Le texte complet de cet article est disponible en PDF.Key Words : Interviews, Qualitative, Trial, Intervention, Nudging, Culture
Plan
| Funding/support: Supported by Deb Australia and Deb Group UK. |
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| Conflicts of interest: None to report. |
Vol 45 - N° 3
P. 222-227 - mars 2017 Retour au numéro
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