Influence of Role Models and Hospital Design on the Hand Hygiene of Health-Care Workers

摘要

We assessed the effect of medical staff role models and thenumber of health-care worker sinks on hand-hygiene compli-ance before and after construction of a new hospital designedfor increased access to handwashing sinks. We observedhealth-care worker hand hygiene in four nursing units that pro-vided similar patient care in both the old and new hospitals:medical and surgical intensive care, hematology/oncology, andsolid organ transplant units. Of 721 hand-hygiene opportuni-ties, 304 (42%) were observed in the old hospital and 417(58%) in the new hospital. Hand-hygiene compliance was sig-nificantly better in the old hospital (161/304; 53%) compared tothe new hospital (97/417; 23.3%) (p<0.001). Health-care work-ers in a room with a senior (e.g., higher ranking) medical staffperson or peer who did not wash hands were significantly lesslikely to wash their own hands (odds ratio 0.2; confidence inter-val 0.1 to 0.5); p<0.001). Our results suggest that health-careworker hand-hygiene compliance is influenced significantly bythe behavior of other health-care workers. An increased num-ber of hand-washing sinks, as a sole measure, did not increasehand-hygiene compliance