Symposia/Symposium
Developing a self-regulation intervention to increase healthcare worker hand-hygiene behaviour
J. MCateer
UCL
S. Stone
Royal Free & University College Medical School
C. Fuller
Royal Free & University College Medical School
R. Slade
Royal Free & University College Medical School
S. Michie
UCL
Background
Evidence-based guidelines for healthcare worker (HCW) hand-hygiene behaviours (HHB; use of soap and alcohol hand-rub) are poorly implemented. This study aimed to develop and implement a theory-based, sustainable and effective intervention to increase HHBs. It informs part of a national study, evaluated by outcome measures of observed HHB, alcohol-rub and soap consumption and healthcare-associated infection.
Method
A literature review of interventions to change healthcare worker hand-hygiene behaviour was conducted to inform the theoretical basis. Seven one-hour focus groups were conducted with 44 HCWs at two NHS hospitals to model a feasible intervention, which was piloted on seven wards across three hospitals. Implementation was assessed by checklists and activity forms; data were analysed by content and theme.
Findings
The review identified self-regulation theories (SRT) of Locke and Latham, and Carver and Scheier, as a basis for effective interventions. Focus group findings indicated the SRT techniques of goal-setting, feedback, and action planning to be feasible. The resulting intervention comprises monthly ward led HHB observation, feedback of performance and action planning at individual and ward levels. Implementation data demonstrate the sustainability of the individual level components but have led to modifications at the ward level, with less emphasis on communication at ward meetings and more using visual displays.
Discussion
This study demonstrates the process of developing a theory-based intervention in practice, targeting both individual and organisational levels. The process comprised theory identification, modelling intervention components suggested by theory, piloting feasibility and assessing implementation.
