Comparing observed with self-reported hand hygiene adherence among bedside nurses and physicians at two hospitals in the United States - 20/02/26
, Sanjay Saint, MD, MPH c, d, Karen E. Fowler, MPH c, Serene Jacob, MSN, RN c, e, Laura Dillon, MS f, Michelle Espiritu, MBBS g, Nathan Houchens, MD c, d, Huberta T. Cozart, PhD, RN h, i, Barbara W. Trautner, MD, PhD f, gRésumé |
Background |
Hand hygiene is a core component of infection prevention in healthcare settings. One potential reason for lack of adherence to recommended hand hygiene practices is erroneous self-perception. We aimed to compare perceptions about hand hygiene compliance with objective data.
Methods |
Direct observations of hand hygiene performance by nurses and physicians during typical workflow in inpatient general medicine wards were conducted from 12 September 2022 to 27 October 2022 at two academic Veterans Affairs medical centers. Participants were surveyed regarding perceptions about their hand hygiene performance relative to recommended practices.
Results |
Among nurses, hand hygiene was performed in 1,397/3,690 (37.9%) room entry and 2,159/4,012 (53.8%) room exit opportunities (combined adherence, 46.2%). For physicians, hand hygiene was performed in 1,016/1,237 (82.1%) room entry and 1,073/1,285 (83.5%) room exit opportunities (combined adherence, 82.8%). Surveys were collected from 92/161 nurses (57.1%) and 189/294 physicians (64.3%). Nurses self-reported compliance in 95.1% of recommended situations, while physicians self-reported 91.0%.
Conclusions |
We found a disconnect between actual and perceived adherence to hand hygiene recommendations among bedside nurses and physicians in inpatient general medicine wards. This disconnect may be due to social desirability, self-serving, or overestimation biases, or time pressures. Awareness of such a disconnect may help policymakers increase hand hygiene rates.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Nurses and physicians self-reported they perform hand hygiene with > 90% adherence. |
• | This study showed a marked difference between self-reported and observed hand hygiene. |
• | Reasons include social desirability bias, self-serving bias, overestimation bias, and time pressures. |
Key Words : Infection prevention, Behavior observation, Social desirability, Subconscious bias
Plan
| ☆ | Previous Publication: Some findings described in this manuscript were presented in preliminary form as a poster abstract at the IDWeek conference in Los Angeles, California, in October 2024. |
| Funding/support: This work was supported by the Department of Veterans Affairs Office of Research and Development (grant number HSR IIR 19-097). BWT’s work is supported in part by VA Health Systems Research CIN 13-413. |
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| Conflicts of interest: None of the authors have any conflicts of interest to disclose. |
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| Disclaimer: This work does not necessarily represent the views of the United States Government or the Department of Veterans Affairs. |
Vol 54 - N° 3
P. 241-246 - mars 2026 Retour au numéro
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