Valerie Ness In the patient zone: healthcare staff’s perceptions of the 5 - PowerPoint Presentation

Slide1

Valerie Ness

In the patient zone: healthcare staff’s perceptions of the 5

th

moment

Funded by the Scottish Infection Research Network (SIRN)

Project management group:

Robin

Creelman

, Lesley

Price,

Lisa Ritchie, Jackie

McIntyre,

Donald

Bunyan,

Jon

Godwin,

Stefan Morton and Jacqui Reilly

Background

Hand hygiene – one of the most

effective measures

in reducing & preventing avoidable illnessWHO’s “5 moments for hand hygiene”Compliance less for 5th moment

Research aim & questions

Aim

:

To evaluate healthcare staff’s perceptions of the WHO hand hygiene moment 5 relative to compliance with this momentQuestions:Do healthcare staff comply with moment 5 in practice?Does compliance with moment 5 vary between professional groups or in different contexts?What are healthcare staff’s perceptions of moment 5?

Do healthcare staff’s perceptions of moment 5 vary across the professional group?

Is there an association between healthcare staff’s hand hygiene behaviour and their perceptions of moment 5?

Mixed method design

Focus groups

Development of self-report

questionnairePurposive sample of healthcare staff from 3 Scottish Health Boards

Non-participant

observation

Completion of self-report

questionnaire

Clinical

Area

N/M/AHP/ ANC-O

N/M/

AHP/ ANC-O

N/M/

AHP/ANC-O

N/M/

AHP/ ANC-ON/M/AHP/ ANC-OParticipant number * Gr     EventTalking to patients      Drug round      Ward round      Catering      Toileting      Transferring      Cleaning       Observations      Documentation       Other: please specify      SettingBed/Trolley/Chair      Bathroom      Dayroom      Treatment room       Sluice      Other: please specify      Room Single       Shared      ‘Patient zone’Locker      Bed rail      Bed/Trolley/Chair      Door handle      Curtains      Bed linen      Bed table       Equipment: please specify      Other: please specify      Final action Use alcohol rub      Wash hands      No hand hygiene     Next moment1      2      3      4      5     

Data Collection – observation tool

Self-report questionnaire

Could

you answer the following questions in relation to:

“In the prevention of infection, the 5th

moment for hand hygiene (after touching the patient’s surroundings) is…”

Clearly defined

[ ]

 [ ] [ ] [ ] [ ] Not clearly defined  Unachievable [ ] [ ] [ ] [ ] [ ] Achievable  Essential [ ] [ ] [ ] [ ] [ ] Not essential  Too time consuming [ ] [ ] [ ] [ ] [ ] Not too time consuming  Encouraged [ ] [ ] [ ] [ ] [ ] Not encouraged  Not valuable [ ] [ ] [ ] [ ] [ ] Valuable  Not repetitive [ ] [ ] [ ] [ ] [ ] Repetitive  Not widely known  [ ] [ ] [ ] [ ] [ ] Widely known

Data analysis

SPSS

Mostly nonparametric tests

1st stage:

- distributions

and frequencies

2

nd

stage:

- Chi-squared tests/Fisher’s Exact test - Mann-Whitney U test/Krustal-Wallis/t-tests

Results

410/484 returned questionnaires (response rate 84%)

404 could be matched to observation data

93% either washed their hands, used alcohol gel or did both at Moment 5

No

significant differences across

professionals regarding compliance with Moment 5

(Heterogeneity

χ²3=5.3, 1p=0.2)Significant differences in relation to compliance with Moment 5 across the health boards (χ²3 (2) =10.3, 1p=0.006)

Results – healthcare staff’s perceptions of the 5

th

moment

Overall positive77% essential71% clearly defined

70% encouraged

69% achievable

65% widely known

56% not too time-consuming

Only

negative60% repetitive

Results – Group differences in healthcare staff’s views

Significant

difference between medical staff and ancillary

staff, where medical staff felt it was “less essential” and “less encouraged” than ancillary staff

Professional

group

Statistic

Defined

Achievable

EssentialTimeconsumingEncouragedValuableRepetitiveWidelyknownMedical staffmean0.920.790.810.520.420.90 0.85Ancillary/othermean1.221.251.560.821.181.45-1.071.07t-test min.2p 0.10.02<0.001**0.2<0.001**0.0050.030.3

Results - relationship between staff

perceptions

& hand hygiene practice

Only significant variable was “widely known” –those who performed hand hygiene scored “widely known” higher than those who did not (p=<0.001)

Discussion

93%

compliance with Moment 5

is still less than the 96% national compliance level for all hand hygiene opportunities

Differences between health

boards

Staff perceptions about being widely known

No significant differences

in health

professionals compliance but differences in perceptions (encouraged, essential)Repetitive

Conclusion

Although staff are positive about the 5

th

Moment & compliance is high, it is not optimumIncreased staff

awareness & understanding of Moment 5 may

enhance compliance

Thank you. Any questions?